Listeria rhomboencephalomyelitis complicated by hemorrhagic transformation

A 53-year-old woman presented with a 2-week history of diplopia, ataxia, and fevers. Blood cultures and CSF PCR were positive for Listeria monocytogenes. MRI demonstrated hyperintensity in the cerebellum, brainstem, and cervical cord (figure 1) with interval hemorrhagic transformation (figure 2). While a recognized cause of rhomboencephalitis, Listeria rarely involves the spinal cord concurrently.1 Hemorrhagic transformation is a novel finding, possibly secondary to bacterial invasion with localized inflammation and necrosis of brain parenchyma and surrounding blood vessels leading to exudation of blood products. Correlating with clinical improvement after treatment with IV ampicillin, progress MRI demonstrated resolution of the hyperintensities.

Source: Neurology - August 21, 2017 Category: Neurology Authors: Nham, B., Baskin, J., Choong, H. Tags: MRI, Meningitis, Bacterial infections, Spinal cord infection NEUROIMAGES Source Type: research