Vasconcelos Mafalda, Moreira Ana Patrícia, Pereira Carla Sofia, Duarte Armindo Rui, Noronha Carla
Internal Medicine, Hospital Beatriz Ângelo, Lisbon, PRT.
Neuroradiology, Hospital Beatriz Ângelo, Lisbon, PRT.
Cureus. 2024 Feb 20;16(2):e54521. doi: 10.7759/cureus.54521. eCollection 2024 Feb.
is a Gram-positive bacillus that presents a tropism for the central nervous system (CNS). In fact, CNS involvement occurs in over two-thirds of infections caused by this agent. Meningitis is the most common manifestation, while brain abscess is rare. We present the case of a 77-year-old male patient on corticosteroid treatment for bronchiolitis obliterans organizing pneumonia with a history of unpasteurized cheese consumption, who presented with fever and altered mental status. Brain computerized tomography scan revealed left frontal cortico-subcortical hypodensity mimicking an ischemic stroke. Subsequent magnetic resonance imaging revealed a brain abscess, and blood cultures yielded . A good clinical outcome was achieved after appropriate antimicrobial therapy and abscess drainage. This case underscores the importance of considering in CNS infections, especially in immunocompromised individuals over 65 years of age. The atypical supratentorial involvement challenges the more common rhombencephalitis presentation. Maintaining a high level of suspicion in relevant populations is crucial for timely diagnosis and intervention, especially in patients with comorbidities, who present particularly high mortality rates.
是一种革兰氏阳性杆菌,对中枢神经系统(CNS)具有嗜性。事实上,该病原体引起的感染中,超过三分之二会累及中枢神经系统。脑膜炎是最常见的表现,而脑脓肿则很少见。我们报告一例77岁男性患者,因患有闭塞性细支气管炎并机化性肺炎接受皮质类固醇治疗,有食用未杀菌奶酪的病史,出现发热和精神状态改变。脑部计算机断层扫描显示左额叶皮质下低密度影,类似缺血性中风。随后的磁共振成像显示有脑脓肿,血培养结果为 。经过适当的抗菌治疗和脓肿引流后,取得了良好的临床效果。该病例强调了在中枢神经系统感染中考虑 的重要性,特别是在65岁以上的免疫功能低下个体中。幕上非典型受累对更常见的菱形脑炎表现提出了挑战。在相关人群中保持高度怀疑对于及时诊断和干预至关重要,特别是对于合并症患者,他们的死亡率特别高。