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Prolonged dysphagia due to Listeria-rhombencephalitis with brainstem abscess and acute polyradiculoneuritis

We report a case of previously healthy student with acute rhombencephalitis and brainstem abscess caused by Listeria monocytogenes. The disease begun with uncharacteristic prodromal symptoms of gastrointestinal infection followed by headache and vertigo. After hospital admission the patient rapidly...

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Published in:	The Journal of infection 2006-06, Vol.52 (6), p.e165-e167
Main Authors:	Smiatacz, Tomasz, Kowalik, Maciej Michal, Hlebowicz, Maria
Format:	Article
Language:	English
Subjects:	Acute polyradiculoneuritis Adult Ampicillin - administration & dosage Anti-Bacterial Agents - administration & dosage Brain Abscess - etiology Brain Stem - pathology Brainstem abscess Deglutition Disorders - etiology Dysphagia Encephalitis - complications Encephalitis - diagnosis Encephalitis - drug therapy Gentamicins - administration & dosage Humans Listeria monocytogenes Listeriosis - complications Listeriosis - diagnosis Listeriosis - drug therapy Male Polyradiculoneuropathy - etiology Respiration, Artificial Respiratory Insufficiency - etiology Respiratory Insufficiency - therapy Rhombencephalitis Treatment Outcome
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description	We report a case of previously healthy student with acute rhombencephalitis and brainstem abscess caused by Listeria monocytogenes. The disease begun with uncharacteristic prodromal symptoms of gastrointestinal infection followed by headache and vertigo. After hospital admission the patient rapidly deteriorated, presenting pronounced dysphagia and respiratory failure requiring mechanical ventilation. The diagnosis was established upon clinical symptoms of infection, brainstem involvement, typical MRI findings and positive for L. monocytogenes blood culture. Infection was complicated by acute, demyelinating neuropathy, diagnosed upon clinical symptoms of frail palsy confirmed by ENG. Initially introduced empirical doxycyclin/ceftriaxon treatment was subsequently changed to targeted ampicillin/gentamycin therapy, mechanical ventilation, intravenous human immunoglobulin treatment, tracheostomy and endoscopic gastrostomy. Prolonged dysphagia resolved after rehabilitation. After one year the patient remains well with only slight dysmetria.
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subjects	Acute polyradiculoneuritis Adult Ampicillin - administration & dosage Anti-Bacterial Agents - administration & dosage Brain Abscess - etiology Brain Stem - pathology Brainstem abscess Deglutition Disorders - etiology Dysphagia Encephalitis - complications Encephalitis - diagnosis Encephalitis - drug therapy Gentamicins - administration & dosage Humans Listeria monocytogenes Listeriosis - complications Listeriosis - diagnosis Listeriosis - drug therapy Male Polyradiculoneuropathy - etiology Respiration, Artificial Respiratory Insufficiency - etiology Respiratory Insufficiency - therapy Rhombencephalitis Treatment Outcome
title	Prolonged dysphagia due to Listeria-rhombencephalitis with brainstem abscess and acute polyradiculoneuritis
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