Mohan Shalini A, Sufyaan Zharif
Department of Internal Medicine, Ampang Hospital, Ampang, Selangor, Malaysia.
Case Rep Infect Dis. 2023 May 22;2023:7405556. doi: 10.1155/2023/7405556. eCollection 2023.
Cerebritis and infective endocarditis caused by are very rare. A 56-year-old man presented with slurring of speech and generalized body weakness of 1 week duration. He did not have any past medical history. On systemic examination, he had mild slurring of speech and facial asymmetry and was initially treated for multifocal chronic cerebral infarcts. was isolated from blood culture on day 5 of admission. A diagnosis of neurolisteriosis was made as contrast-enhanced-computed tomography (CECT) of the brain showed right frontal cerebritis. He was treated with intravenous benzyl penicillin. His general condition was improving until day 13 of hospitalization whereby he developed haemoptysis and severe Type 1 respiratory failure requiring reintubation. An urgent transthoracic echocardiogram revealed a large vegetation at the anterior mitral valve leaflet measuring 2.01 cm. No active arterial bleeding was seen on computed tomography angiography (CTA) of the thorax. Magnetic resonance imaging (MRI) of the brain showed evidence of right frontal cerebritis. He continued to deteriorate and succumbed to his illness after 3 weeks of hospitalization. Clinicians should be aware of such an occurrence and prompt recognition and adequate treatment are necessary in cases of cerebritis and infective endocarditis as both are deadly entities.
由[病原体未提及]引起的脑脊髓炎和感染性心内膜炎非常罕见。一名56岁男性出现言语不清和全身乏力，持续1周。他既往无任何病史。全身检查时，他有轻度言语不清和面部不对称，最初被诊断为多灶性慢性脑梗死并接受治疗。入院第5天血培养分离出[病原体未提及]。脑部增强计算机断层扫描（CECT）显示右额叶脑脊髓炎，从而诊断为神经李斯特菌病。他接受了静脉注射苄星青霉素治疗。直到住院第13天，他的一般状况一直在改善，然而此时他出现咯血和严重的1型呼吸衰竭，需要重新插管。紧急经胸超声心动图显示二尖瓣前叶有一个2.01厘米的大赘生物。胸部计算机断层血管造影（CTA）未发现活动性动脉出血。脑部磁共振成像（MRI）显示右额叶脑脊髓炎的迹象。他的病情继续恶化，住院3周后死亡。临床医生应意识到这种情况的发生，对于脑脊髓炎和感染性心内膜炎病例，及时识别和充分治疗是必要的，因为这两种情况都是致命的。
