Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2022; 10(22): 7924-7930
Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7924
Brainstem abscesses caused by Listeria monocytogenes: A case report
Jie Wang, Yu-Chen Li, Ke-Yu Yang, Jing Wang, Zan Dong
Jie Wang, Yu-Chen Li, Jing Wang, Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
Ke-Yu Yang, Department of Critical Care Medicine, Aerospace Center Hospital, Beijing 100049, China
Zan Dong, Department of Neurology, Yuncheng Central Hospital, Yuncheng 043100, Shanxi Province, China
Author contributions: Dong Z and Wang J contributed to conceptualization and data collection; Yang KY reviewed the literature and contributed to manuscript drafting; Wang J and Li YC performed data interpretation; Wang J was responsible for the revision of the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Informed consent statement: The patient described in this article signed a consent document authorizing us to use his information.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie Wang, Professor, Doctor, Occupational Physician, Department of Neurology, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan 030000, Shanxi Province, China. luwanglu2012@163.com.
Received: November 22, 2021
Peer-review started: November 22, 2021
First decision: January 11, 2022
Revised: January 23, 2022
Accepted: June 17, 2022
Article in press: June 17, 2022
Published online: August 6, 2022
Processing time: 241 Days and 15.4 Hours
Abstract
BACKGROUND

Intracranial Listeria infections are common in newborns and immunocompromised individuals, but brainstem abscesses are rare.

CASE SUMMARY

We report a rare case of brainstem abscesses caused by Listeria monocytogenes in a previously healthy adult patient. The patient’s magnetic resonance imaging examination showed multiple brain abscesses, and his second cerebrospinal fluid culture test indicated the presence of Listeria monocytogenes. Despite early empirical therapy, the patient’s condition progressively deteriorated. Because the patient's abscesses were located in the brainstem and multiple lobes, surgery was not possible. The patient died 40 d after admission.

CONCLUSION

This case highlights the importance of rational clinical use of drugs to avoid potentially serious infectious complications.

Keywords: Listeria monocytogenes; Brainstem abscesses; Drug; Brain MRI; Therapy; Prognosis; Case report

Core Tip: Listeria monocytogenes, an opportunistic pathogen, can be life-threatening when it infects the central nervous system (CNS). Herein, we report the case of a patient presenting with fever, headache, emesis, and perturbed consciousness. His condition rapidly deteriorated after empiric antibiotic therapy. He was finally diagnosed with Listeria monocytogenes infection after re-examination. Despite a timely change in his medication regimen, the patient died. This case highlights the importance of rational clinical antibiotic therapy to avoid potentially serious infectious complications. When empiric antibiotic therapy fails, and Listeria infection of the CNS is suspected, bacterial culture should be repeated for timely adjustment of antibiotics.