The rapidly progressing and fatal outcome of rhombencephalitis by listeriosis in a 61-year-old male

Urszula Skrobas, Whitley Zie, Joanna Bielewicz, Konrad Rejdak
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Abstract

Listeria monocytogenes is a Gram-positive facultative anaerobic bacterium that is ubiquitous in the environment and can cause severe infections in immunocompromised individuals, pregnant women, and newborns. Listeriosis can manifest as meningitis, encephalitis, or sepsis, and its diagnosis requires a high index of suspicion. The case is reported of a rare presentation of rhombencephalitis by listeriosis in a 61-year-old male who initially suffered from subacute gastric disturbances and fever. Neurological consultation showed abnormal functions of cranial nerves and meningeal signs were observed. MRI revealed a poorly demarcated focus of approximately 45 × 16 × 15mm, indicating possible inflammatory processes, necessitating a lumbar puncture. Assessment of the CSF indicated infection with the bacterium-Listeria Monocytogenes, with the final diagnosis of Listeriosis encephalitis. Despite antibiotic therapy of Ceftazidine and Ampicillin, the patient’s condition deteriorated, followed by death.
一名 61 岁男性因李斯特菌病引发的急速进展和致命结局的伦脑炎
单核细胞增生李斯特菌是一种革兰氏阳性兼性厌氧菌,在环境中无处不在,可引起免疫力低下者、孕妇和新生儿的严重感染。李斯特菌病可表现为脑膜炎、脑炎或败血症,其诊断需要高度怀疑。本病例报告了一例罕见的李斯特菌病引起的菱形脑炎,患者是一名 61 岁的男性,最初出现亚急性胃肠功能紊乱和发热。神经科会诊显示颅神经功能异常,并观察到脑膜体征。核磁共振成像显示一个约 45 × 16 × 15 毫米的病灶界限不清,表明可能存在炎症过程,因此有必要进行腰椎穿刺。脑脊液评估显示感染了单增李斯特菌,最终诊断为李斯特菌病脑炎。尽管接受了头孢他啶和氨苄西林等抗生素治疗,但患者病情恶化,随后死亡。
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