Décard Bernhard F, Thöne Jan, Haghikia Aiden, Börnke Christian, Anders Agnes, Lukas Carsten, Gold Ralf
Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany/Department of Neurology, University Hospital Basel, Basel, Switzerland.
Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany/Department of Neurology, University Hospital Essen, Essen, Germany.
Mult Scler. 2017 Jan;23(1):123-125. doi: 10.1177/1352458516650522. Epub 2016 Jul 20.
Listeriosis caused by listeria monocytogenes (LM) is a potentially lethal foodborne infection of the central nervous system (CNS) and the third most common cause of bacterial meningitis. Foods most commonly implicated are soft cheeses, raw or ready-to-eat meat and pre-processed foods. The incubation time is between 11 and 70 days. Rarely LM rhombencephalitis (RE) can occur, which typically has a biphasic course with non- specific prodromal symptoms like fever, malaise, fatigue, headache, nausea and vomiting followed by cranial nerve palsies, ataxia and hemi- or tetraparesis.
To report a 31-year old immunocompetent female developing a severe abscessing RE caused by LM, which was initially assessed as a relapse after a clinically isolated syndrome (CIS).
Case report.
Patients with CIS or multiple sclerosis, who present with brainstem symptoms should be evaluated carefully. The presence of clinical and paraclinical red flags in the diagnostic evaluation of a suspected CNS white matter disease should raise the awareness of clinicians for potential differential diagnoses.
由单核细胞增生李斯特菌（LM）引起的李斯特菌病是一种潜在致命的中枢神经系统食源性感染，也是细菌性脑膜炎的第三大常见病因。最常涉及的食物是软奶酪、生的或即食肉类以及预加工食品。潜伏期为11至70天。罕见情况下会发生LM型菱形脑炎（RE），其通常呈双相病程，伴有发热、不适、疲劳、头痛、恶心和呕吐等非特异性前驱症状，随后出现脑神经麻痹、共济失调和半身或四肢轻瘫。
报告一名31岁免疫功能正常的女性发生由LM引起的严重脓肿性RE，该病例最初被评估为临床孤立综合征（CIS）后的复发。
病例报告。
患有CIS或多发性硬化症且出现脑干症状的患者应进行仔细评估。在疑似中枢神经系统白质疾病的诊断评估中，临床和辅助检查警示信号的出现应提高临床医生对潜在鉴别诊断的认识。
