Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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December 21, 2009
Listeria Rhombencephalitis
- Listeria monocytogenes is an anaerobic, gram-positive bacilus that primarily affects immunocompromised hosts and is uncommon in the general population.
- Rhombencephalitis is a particular form of listerial encephalitis that affects primarily the brainstem and cerebellum.
- MRI is important in demonstrating predilection of listerial infection for the brainstem/cerebellum. These regions may also be involved in viral encephalitis, lymphoma, vasculitis (systemic lupus erythematosus, Behcet disease), sarcoidosis, tuberculosis, multiple sclerosis and acute disseminated encephalomyelitis.
- Suspect listerial rhombencephalitis in presence of acute onset of progressive cranial nerve dysfunction and ataxia, CSF leukocytosis with polymorphonuclear cell predominance (nl glucose) and MRI findings of brainstem (primarily pontomedullary) and cerebellar lesions.
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