Caminero Rodríguez A B, Serrano Herranz R, Sánchez Ramírez F, Benito Gómez J
Servicio de Neurología, Hospital Nuestra Señora de Sonsoles, Avila.
Neurologia. 1995 Oct;10(8):342-5.
We report a case of rhombencephalitis with meningitis in a 36-years-old previously healthy man; neurological signs and symptoms were initially consistent with a diagnosis of Wallenberg syndrome. Analysis of cerebrospinal fluid showed predominantly lymphocytic pleocytosis and elevated protein levels. A CT brain scan was normal. MRI of the brain showed a hypertensive type lesion in T2, in the right pontomedullary region that suggested inflammation. A blood culture grew Listeria monocytogenes. The patient improved and fully recovered with appropriate antibiotic treatment. Listeria monocytogenes is a recognized cause of acute brainstem meningoencephalitis. Differential diagnoses that must be considered are other forms of purulent meningitis, viral meningoencephalitis, granulomatosis infections of the central nervous system and, occasionally, stroke.
我们报告一例36岁既往健康男性患菱形脑炎合并脑膜炎的病例；神经体征和症状最初与瓦伦贝格综合征的诊断相符。脑脊液分析显示以淋巴细胞增多为主且蛋白水平升高。脑部CT扫描正常。脑部MRI显示右侧脑桥延髓区域T2加权像上有一个高血压型病变，提示炎症。血培养培养出单核细胞增生李斯特菌。患者经适当的抗生素治疗后病情好转并完全康复。单核细胞增生李斯特菌是急性脑干脑膜脑炎的公认病因。必须考虑的鉴别诊断包括其他形式的化脓性脑膜炎、病毒性脑膜脑炎、中枢神经系统肉芽肿性感染以及偶尔的中风。
