Acute ischaemic stroke in Listeria monocytogenes meningoencephalitis
| Autor: | Jennifer Boyes, George Thomas, Surrin S. Deen, Bankole Oyewole, Gunaratnam Gunathilagan, Anna Bahk |
|---|---|
| Přispěvatelé: | Deen, Surrin S [0000-0002-6206-7337], Apollo - University of Cambridge Repository |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Aging
32 Biomedical and Clinical Sciences Case Report FOS: Health sciences medicine.disease_cause 030218 nuclear medicine & medical imaging Microbiology Vaccine Related 03 medical and health sciences 0302 clinical medicine Listeria monocytogenes Clinical Research Ischaemic stroke Medicine 3202 Clinical Sciences biology business.industry FOS: Clinical medicine Neurosciences Meningoencephalitis General Medicine Foodborne Illness biology.organism_classification medicine.disease Brain Disorders Stroke Emerging Infectious Diseases Infectious Diseases 030220 oncology & carcinogenesis Listeria Biomedical Imaging Bacterial meningitis Digestive Diseases Infection business |
| Zdroj: | BJR | case reports |
| ISSN: | 2055-7159 |
| Popis: | Listeria monocytogenes is the third most frequent cause of bacterial meningitis and has a predilection for elderly patients and the immunosuppressed. A small number of patients with Listeria monocytogenes meningoencephalitis have previously been reported to experience stroke-like symptoms that were attributed to microabscess formation and the mass effect of collections of infection in the brain. These infections led to temporary neurological deficits that resolved with antimicrobial treatment, rather than to true strokes with permanent neurological deficits. This report discusses the case of an 80- year-old male, who was immunosuppressed with mesalazine for the treatment of Crohn’s disease, and who went on to develop Listeria monocytogenes meningoencephalitis. 1 week into his admission, for antibiotic therapy, the patient began to experience new onset right upper limb weakness, nystagmus and past pointing. These symptoms were initially thought to be a complication of the infection. However, subsequent diffusion-weighted MRI revealed that the patient had more likely suffered an acute ischaemic event and a contrast-enhanced MRI performed later could not detect any abscess or large infective focus in a region that could explain the symptoms. This case report highlights the fact that ischaemic and infective pathologists may coexist in immunosuppressed Listeria patients and that clinical signs and symptoms should guide the use of appropriate imaging modalities such as MRI to clarify differentials so that ischaemia is not mistaken for the more common stroke mimic caused by infection in these patients. |
| Databáze: | OpenAIRE |
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