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Kim DD, Sadic M, Yarabe B, Loftus JR, Lieberman E, Young MG, Jain R, Dogra S. Listeria monocytogenes brain abscesses presenting as contiguous, tubular rim-enhancing lesions on Magnetic Resonance Imaging: Case series and literature review. Neuroradiol J 2024:19714009241240054. [PMID: 38494758 DOI: 10.1177/19714009241240054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Listeriosis has more than a 50% mortality when the central nervous system is involved, necessitating rapid diagnosis and treatment. We present four patients with brain abscesses in the setting of diagnosed neurolisteriosis, all of which demonstrated an odd presentation of multiple small, contiguous tubular lesions with rim enhancement on magnetic resonance imaging. Our review of published cases of neurolisteriosis suggests that this may be a useful pattern to identify neurolisteriosis abscesses, allowing earlier detection and therapy.
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Affiliation(s)
- Daniel D Kim
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Mohammad Sadic
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Boniface Yarabe
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - James R Loftus
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Evan Lieberman
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Matthew G Young
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Rajan Jain
- Department of Radiology, New York University Langone Health, New York, NY, USA
- Department of Neurosurgery, New York University Langone Health, New York, NY, USA
| | - Siddhant Dogra
- Department of Radiology, New York University Langone Health, New York, NY, USA
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Ponnambath DK, Kaviyil JE, Raja K, Abraham M, Thomas B. A Rare Case of Cerebellar Abscess due to Listeria Monocytogenes in an Elderly Patient with Ulcerative Colitis. Neurol India 2022; 70:1692-1693. [PMID: 36076693 DOI: 10.4103/0028-3886.355159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Dinoop K Ponnambath
- Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Jyothi E Kaviyil
- Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Kavita Raja
- Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Mathew Abraham
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Bejoy Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
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3
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Bagatella S, Tavares-Gomes L, Oevermann A. Listeria monocytogenes at the interface between ruminants and humans: A comparative pathology and pathogenesis review. Vet Pathol 2021; 59:186-210. [PMID: 34856818 DOI: 10.1177/03009858211052659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The bacterium Listeria monocytogenes (Lm) is widely distributed in the environment as a saprophyte, but may turn into a lethal intracellular pathogen upon ingestion. Invasive infections occur in numerous species worldwide, but most commonly in humans and farmed ruminants, and manifest as distinct forms. Of those, neuroinfection is remarkably threatening due to its high mortality. Lm is widely studied not only as a pathogen but also as an essential model for intracellular infections and host-pathogen interactions. Many aspects of its ecology and pathogenesis, however, remain unclear and are rarely addressed in its natural hosts. This review highlights the heterogeneity and adaptability of Lm by summarizing its association with the environment, farm animals, and disease. It also provides current knowledge on key features of the pathology and (molecular) pathogenesis of various listeriosis forms in naturally susceptible species with a special focus on ruminants and on the neuroinvasive form of the disease. Moreover, knowledge gaps on pathomechanisms of listerial infections and relevant unexplored topics in Lm pathogenesis research are highlighted.
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Affiliation(s)
- Stefano Bagatella
- Division of Neurological Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Leticia Tavares-Gomes
- Division of Neurological Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Anna Oevermann
- Division of Neurological Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Cipriani D, Trippel M, Buttler KJ, Rohr E, Wagner D, Beck J, Schnell O. Cerebral Abscess Caused by Listeria monocytogenes: Case Report and Literature Review. J Neurol Surg A Cent Eur Neurosurg 2021; 83:194-205. [PMID: 34496414 DOI: 10.1055/s-0041-1729174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Listeria monocytogenes is an opportunistic gram-positive, facultative intracellular bacterium that causes invasive diseases mostly in pregnant women and immunosuppressed patients. Despite the predilection toward the central nervous system (CNS), it usually causes meningitis and meningoencephalitis, whereas brain abscesses are very uncommon. CASE PRESENTATION We describe the case of a 69-year-old homeless patient with a brain abscess due to L. monocytogenes who was successfully treated surgically by a guided stereotactic aspiration and antibiotic therapy with ampicillin and gentamicin. Our patient was discharged after 4 weeks of therapy without neurologic deficits. Additionally, we provide a review of the literature of brain abscesses caused by L. monocytogenes. CONCLUSIONS This case highlights the need to drain cerebral abscesses and culture pus to correctly treat patients with antibiotics, especially given the high mortality rate of this infectious entity.
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Affiliation(s)
- Debora Cipriani
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany
| | - Michael Trippel
- Department of Stereotactic and Functional Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany
| | - Klaus-Jürgen Buttler
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany
| | - Eva Rohr
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany
| | - Dirk Wagner
- Department of Medicine II, Division of Infectious Diseases, Medical Center University of Freiburg, Freiburg, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany
| | - Oliver Schnell
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany
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Douchy T, Lagrou K, Jochmans I, Sainz Barriga M, Monbaliu D, Pirenne J, Debaveye Y. Solid organ donation after death from listeria encephalitis: A case report. Transpl Infect Dis 2020; 22:e13295. [PMID: 32303115 DOI: 10.1111/tid.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/06/2020] [Accepted: 04/12/2020] [Indexed: 11/30/2022]
Abstract
Despite organ shortage, organs from donors with listeria infections have been discarded for transplantation. We present the first-reported case of liver transplantation following listeria encephalitis. The patient was admitted with progressing neurological symptoms after an episode of gastroenteritis. Rhombo-encephalitis was diagnosed, and Listeria monocytogenes was found to be the causative pathogen. Despite proper antibiotic treatment and rapid clearance of bacteremia, he continued to deteriorate and became brain dead, after which organ donation was performed. At procurement, he had been treated with amoxicillin for 9 days. The recipient was treated with pipercillin/tazobactam for 21 days. Besides an anastomotic biliary stricture, necessitating endoscopic dilatation and stenting, further clinical course was uneventful and she is doing well eleven months post-transplant. Our case suggests that listeria encephalitis is not an absolute contra-indication to solid organ donation. We suggest that donors should be treated with adequate antibiotics for at least 48h prior to procurement and advocate confirmation of sterile blood cultures as a prerequisite for donation. According to listeriosis guidelines, we suggest that the recipient should be treated with targeted antibiotics for at least 2 weeks. The risk of transmission should, however, always be balanced carefully against the suspected waiting list mortality.
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Affiliation(s)
- Thomas Douchy
- Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Clinical Department of Laboratory Medicine, University hospitals Leuven, Leuven, Belgium
| | - Ina Jochmans
- Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.,Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Mauricio Sainz Barriga
- Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.,Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Diethard Monbaliu
- Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.,Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Jacques Pirenne
- Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.,Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Yves Debaveye
- Department of Intensive Care Medicine, University hospitals Leuven, Leuven, Belgium
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Piette E, Vandermeulen M, Meurisse N, Schielke A, Meuris C, Honoré P, Detry O. Early listeriosis after liver transplantation: Report of two cases. Transpl Infect Dis 2019; 21:e13122. [DOI: 10.1111/tid.13122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/22/2019] [Accepted: 05/18/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Estelle Piette
- Department of Abdominal and Transplant Surgery, CHU Liege University of Liege (CHU ULiege) Liege Belgium
| | - Morgan Vandermeulen
- Department of Abdominal and Transplant Surgery, CHU Liege University of Liege (CHU ULiege) Liege Belgium
| | - Nicolas Meurisse
- Department of Abdominal and Transplant Surgery, CHU Liege University of Liege (CHU ULiege) Liege Belgium
| | - Astrid Schielke
- Department of Abdominal and Transplant Surgery, CHU Liege University of Liege (CHU ULiege) Liege Belgium
| | - Christelle Meuris
- Department of Internal Medicine and Infectious Diseases, CHU Liege University of Liege (CHU ULiege) Liege Belgium
| | - Pierre Honoré
- Department of Abdominal and Transplant Surgery, CHU Liege University of Liege (CHU ULiege) Liege Belgium
| | - Olivier Detry
- Department of Abdominal and Transplant Surgery, CHU Liege University of Liege (CHU ULiege) Liege Belgium
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Clinical Presentation and Cranial MRI Findings of Listeria monocytogenes Encephalitis: A Literature Review of Case Series. Neurologist 2018; 23:198-203. [PMID: 30379745 DOI: 10.1097/nrl.0000000000000212] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Listeria monocytogenes-associated encephalitis is a severe clinical condition that can also be seen in immunocompetent patients. Clinical manifestation and radiologic features of this entity need to be elaborated. REVIEW SUMMARY We searched the medical literature during the period spanning from 1991 to 2017 using the keyword "listeria AND [abscess odds ratio (OR) brainstem OR encephalit* OR magnetic* OR imaging*]." We included in the review well-documented adult cases with a definitive diagnosis and having magnetic resonance imaging data. Confusion, hemiparesis, cerebellar ataxia, facial paralysis, and gait disturbance were the most frequent findings, detected in >30% of patients during admission. The high rate of facial paralysis was of particular interest. T2 hyperintensity (80/82), contrast enhancement (60/82), and ring-enhancing lesions, which are considered as brain abscess, were found in 46/82 patients. The mortality and neurological sequel rates were 20% and 68%, respectively. CONCLUSIONS Listeria encephalitis is a severe disease and should be remembered in cases admitted with symptoms related to the brainstem and cranial nerve dysfunction. Cranial magnetic resonance imaging with brainstem and cerebellum involvements and contrast enhancement with or without abscess are particularly suggestive of the listeria-related infection.
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Yakut N, Kadayifci EK, Karaaslan A, Atici S, Akkoc G, Ocal Demir S, Dagcinar A, Akbulut F, Soysal A, Bakır M. Braın abscess due to Streptococcus intermedius secondary to mastoiditis in a child. SPRINGERPLUS 2015; 4:809. [PMID: 26722629 PMCID: PMC4689728 DOI: 10.1186/s40064-015-1608-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/13/2015] [Indexed: 11/13/2022]
Abstract
Background Brain abscess is a rare but serious, life-threatening infection in children. It may arise from parameningeal infections such as otitis media, sinusitis and mastoiditis. Case description A ten-year-old boy with the diagnosis of glycogen-storage disease and obesity was admitted to the emergency room with complaints of vomiting, decreased level of consciousness, imbalance on walking. On neurological examination, the patient was ataxic. His cranial magnetic resonance imaging (MRI) examination showed mastoiditis on the right side and 39 × 34 mm abscess formation with surrounding edema on the right cerebellar hemisphere. The patient underwent surgery to drain the abscess, microbiological samples were obtained and empirical antibiotic treatment with vancomycin and piperacillin–tazobactam were started. Postoperative cranial MRI examination showed that the lesion regressed 10 × 10 mm with a reduction in the edema. On the second week of the treatment, the antibiotics were switched to vancomycin and meropenem because of the relapsing fever. The therapy was continued for 6 weeks. A final MRI (after completing antibiotherapy) showed resolution of the cerebellar abscess. The child’s clinical condition improved and he was discharged without any sequelae. Discussion and evaluation Children with congenital heart disease and an immonocompromised state are particularly at risk. Streptococcus intermedius is usually a commensal microorganism in the normal flora of the mouth which can cause brain abscess rarely in children. Brain abscess induced mortality rates are still relatively high, even with the advancement of imaging technologies, the combination of surgical drainage and antimicrobial therapy. Conclusion This case is one of the few reported cases of cerebellar abscess caused by S. intermedius in an immunocompetent child, due to its low virulence, a rare occurence and timely management resulting in fully healed.
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Affiliation(s)
- Nurhayat Yakut
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Eda Kepenekli Kadayifci
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Ayse Karaaslan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Serkan Atici
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Gulsen Akkoc
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Sevliya Ocal Demir
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Adnan Dagcinar
- Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Fatih Akbulut
- Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Ahmet Soysal
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey ; No 41, Fevzi Cakmak mahallesi, Ustkaynarca, Pendik, Istanbul, Turkey
| | - Mustafa Bakır
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
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Bojanowski MW, Seizeur R, Effendi K, Bourgouin P, Magro E, Letourneau-Guillon L. Spreading of multiple Listeria monocytogenes abscesses via central nervous system fiber tracts: case report. J Neurosurg 2015; 123:1593-9. [PMID: 26090836 DOI: 10.3171/2014.12.jns142100] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Animal studies have shown that Listeria monocytogenes can probably access the brain through a peripheral intraneural route, and it has been suggested that a similar process may occur in humans. However, thus far, its spreading through the central nervous system (CNS) has not been completely elucidated. The authors present a case of multiple L. monocytogenes cerebral abscesses characterized by a pattern of distribution that suggested spread along white matter fiber tracts and reviewed the literature to identify other cases for analysis. They elected to include only those cases with 3 or more cerebral abscesses to make sure that the distribution was not random, but rather followed a pattern. In addition, they included those cases with abscesses in both the brainstem and the cerebral hemispheres, but excluded cases in which abscesses were located solely in the brainstem. Of 77 cases of L. monocytogenes CNS abscesses found in the literature, 17 involved multiple abscesses. Of those, 6 were excluded for lack of imaging and 3 because they involved only the brainstem. Of the 8 remaining cases from the literature, one was a case of bilateral abscesses that did not follow a fiber tract; another was also bilateral, but with lesions appearing to follow fiber tracts on one side; and in the remaining 6, to which the authors added their own case for a total of 7, all the abscesses were located exclusively in the same hemisphere and distributed along white matter fiber tracts. The findings suggest that after entering the CNS, L. monocytogenes travels within the axons, resulting in a characteristic pattern of distribution of multiple abscesses along the white matter fiber tracts in the brain. This report is the first description suggesting intraaxonal CNS spread of L. monocytogenes infection in humans following its entry into the brain. This distinct pattern is clearly seen on imaging and its recognition may be valuable in the diagnosis of listeriosis. This finding may allow for earlier diagnosis, which may improve outcome.
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Affiliation(s)
| | - Romuald Seizeur
- Divisions of 1 Neurosurgery and.,Service de Neurochirurgie, CHRU de Brest, France
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Barrera-Herrera LE, Vera A, Álvarez J, Lopez R. Necrotizing encephalitis caused by disseminated Aspergillus infection after orthotopic liver transplantation. Case Rep Gastroenterol 2015; 9:1-6. [PMID: 25759632 PMCID: PMC4327571 DOI: 10.1159/000371541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Liver transplantation is the only available treatment for some patients with end-stage liver disease. Despite reduction in mortality rates due to advances related to surgical techniques, intensive medical management and immunosuppressive therapy, invasive fungal infections remain a serious complication in orthotopic liver transplantation. We report the case of an 18-year-old male diagnosed with autoimmune cirrhosis in 2009 who was assessed and listed for liver transplantation for massive variceal hemorrhage. One year after listing a successful orthotopic liver transplantation was performed. Uneventful early recovery was achieved; however, he developed pulmonary and neurological Aspergillus infection 23 and 40 days after surgery, respectively. Antibiotic therapy with voriconazole and amphotericin was started early, with no major response. Neuroimaging revealed multiple right frontal and right parietal lesions with perilesional edema; surgical management of the brain abscesses was performed. A biopsy with periodic acid-Schiff and Gomori stains revealed areas with mycotic microorganisms morphologically consistent with Aspergillus, later confirmed by culture. The patient developed necrotizing encephalitis secondary to aspergillosis and died. Necrotizing encephalitis as a clinical presentation of Aspergillus infection in an orthotopic liver transplant is not common, and even with adequate management, early diagnosis and prompt antifungal treatment, mortality rates remain high.
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Affiliation(s)
- Luis E Barrera-Herrera
- Pathology and Clinical Laboratory Department, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
| | - Alonso Vera
- Transplant Service, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia ; School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Johanna Álvarez
- Pathology and Clinical Laboratory Department, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia ; School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Rocio Lopez
- Pathology and Clinical Laboratory Department, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia ; School of Medicine, Universidad de los Andes, Bogotá, Colombia
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