Fever and temporal headache in a 70-year-old male with presumed large vessels vasculitis.
Listerial infection of CNS
brain abscess
cerebritis
listeriosis
Journal
Mediterranean journal of rheumatology
ISSN: 2529-198X
Titre abrégé: Mediterr J Rheumatol
Pays: Greece
ID NLM: 101730166
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
21
07
2019
revised:
10
10
2019
accepted:
14
10
2019
entrez:
18
7
2020
pubmed:
18
7
2020
medline:
18
7
2020
Statut:
epublish
Résumé
Listeria monocytogenes is an opportunistic pathogen that causes severe infections of the Central Nervous System, such as meningitis or meningoencephalitis, and brain abscesses. Abscesses account for approximately 1-10% of CNS listerial infections and are observed in 1% of all listerial infections. We describe a case of 70-year-old male patient who had several admissions in different hospitals over the last 8 weeks. He suffered from intermittent fever for over a month, recurrent episodes of headaches, disorientation and other neurological symptoms. His condition was misdiagnosed as giant cell arteritis and initially the patient was started on corticosteroids. MRI of the brain revealed the presence of multiple brain abscesses and the cerebrospinal fluid study confirmed the presence of Listeria Monocytogenes. The patient was started on ampicillin and he completed a 6 weeks' course of treatment. This case emphasizes the need to include rare pathogens in the differential diagnosis when possible CNS infections are involved, as well as to show that in many cases some auto-immune diseases are overdiagnosed.
Sections du résumé
BACKGROUND
BACKGROUND
Listeria monocytogenes is an opportunistic pathogen that causes severe infections of the Central Nervous System, such as meningitis or meningoencephalitis, and brain abscesses. Abscesses account for approximately 1-10% of CNS listerial infections and are observed in 1% of all listerial infections.
METHODS
METHODS
We describe a case of 70-year-old male patient who had several admissions in different hospitals over the last 8 weeks.
RESULTS
RESULTS
He suffered from intermittent fever for over a month, recurrent episodes of headaches, disorientation and other neurological symptoms. His condition was misdiagnosed as giant cell arteritis and initially the patient was started on corticosteroids. MRI of the brain revealed the presence of multiple brain abscesses and the cerebrospinal fluid study confirmed the presence of Listeria Monocytogenes. The patient was started on ampicillin and he completed a 6 weeks' course of treatment.
CONCLUSIONS
CONCLUSIONS
This case emphasizes the need to include rare pathogens in the differential diagnosis when possible CNS infections are involved, as well as to show that in many cases some auto-immune diseases are overdiagnosed.
Identifiants
pubmed: 32676561
doi: 10.31138/mjr.31.2.220
pii: mjr-31-2-220
pmc: PMC7362124
doi:
Types de publication
Case Reports
Langues
eng
Pagination
220-223Informations de copyright
© 2020 The Mediterranean Journal of Rheumatology (MJR).
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