Department of Internal Medicine, Saint Michael's Medical Center, Newark, NJ, 07102, USA.
New York Medical College, New York, USA.
J Med Case Rep. 2024 Aug 23;18(1):390. doi: 10.1186/s13256-024-04690-1.
Listeria monocytogenes brain abscess is a rare phenomenon that is common in immunocompromised patients. Streptococcus equinus brain abscess has never been reported in the literature to our knowledge. In this case report, we describe a case of brain abscess secondary to Listeria monocytogenes and Streptococcus equinus in an immunocompetent patient with transient low CD4 count.
A 27-year-old white, male patient, previously healthy, nonalcoholic, and occasional smoker, presented to the emergency department for confusion and headache. The patient was found to have a left parietal abscess, which was drained and the fluid was sent for culture. Culture grew Listeria monocytogenes and Streptococcus equinus. The patient was treated with intravenous ampicillin followed by oral amoxicillin for a total of 6 weeks. The CD4 count was low initially. However, after the resolution of the infection, the CD4 count came back within normal range. Another brain magnetic resonance imaging was done that showed a significantly decreased hyperintensity within the left parietal subcortical white matter at the site of surgery with significantly decreased enhancement and almost total resolution of the previous abscess.
Transient low CD4 count is a rare phenomenon that exposes patients to unusual and atypical infections. Since low CD4 count is transient, patients treated promptly recover from their illness. Our patient developed a Listeria monocytogenes and Streptococcus equinus brain abscess, which is considered rare and has not been previously described in the literature to our knowledge.
李斯特菌单核细胞增生症脑脓肿是一种罕见的现象，常见于免疫功能低下的患者。据我们所知，马链球菌脑脓肿在文献中从未被报道过。在本病例报告中，我们描述了一例免疫功能正常的患者，其短暂性 CD4 计数降低，继发李斯特菌单核细胞增生症和马链球菌脑脓肿。
一名 27 岁的白人男性，既往健康，非酗酒者，偶尔吸烟，因意识混乱和头痛到急诊科就诊。患者被发现左顶叶脓肿，进行了引流，将液体送检培养。培养物生长出李斯特菌单核细胞增生症和马链球菌。患者接受了静脉注射氨苄西林，随后口服阿莫西林共 6 周。CD4 计数最初较低。然而，感染得到控制后，CD4 计数恢复到正常范围。另一次脑部磁共振成像显示，手术部位左顶叶皮质下白质内的高信号明显减少，增强明显减少，先前的脓肿几乎完全消退。
短暂性 CD4 计数降低是一种罕见现象，使患者易感染罕见和非典型感染。由于 CD4 计数是短暂性的，因此及时治疗的患者可以从疾病中恢复。我们的患者发展为李斯特菌单核细胞增生症和马链球菌脑脓肿，这被认为是罕见的，据我们所知，在文献中尚未有过描述。
