Supratentorial Listeria monocytogenes Brain Abscess in a Patient with Liver Cirrhosis

• Main Authors: Romulo Omar Flores-Perez, Cesar Daniel Villarreal-Villarreal, Jesus Alberto Cardenas-de La Garza, Dionicio Angel Galarza-Delgado
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Annals of Indian Academy of Neurology
• Subjects: brain abscess; central nervous system infections; listeria; listeriosis
• Online Access: http://www.annalsofian.org/article.asp?issn=0972-2327;year=2020;volume=23;issue=1;spage=107;epage=109;aulast=Flores-Perez
• ISSN: 0972-2327; 1998-3549

Meningitis and meningoencephalitis account for the majority of central nervous system infections by Listeria monocytogenes (Lm). Macroscopic listerial brain abscess is a rare infection. Early recognition of Listeria brain abscesses represents a major diagnostic challenge. Mortality from Listeria brain abscesses is high but can be reduced when appropriate treatment is timely started. Immunosuppressed patients are more often affected, and a high suspicion is needed for prompt identification. Treatment should be individualized taking into account the comorbidities, lesion size and location, bacterial resistance, and clinical and radiological response. We present a case of a supratentorial Lm brain abscess in a patient with liver cirrhosis whose family denied surgical management, and despite the large size, clinical and radiological success was achieved with 4 weeks of ampicillin.