Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2019; 7(4): 538-547
Published online Feb 26, 2019. doi: 10.12998/wjcc.v7.i4.538
Rhombencephalitis caused by Listeria monocytogenes with hydrocephalus and intracranial hemorrhage: A case report and review of the literature
Jing-Jing Liang, Xiao-Yan He, Hong Ye
Jing-Jing Liang, Department of Neurology, Wuhan University, Renmin Hospital, Wuhan 430060, Hubei Province, China
Xiao-Yan He, Department of Neurology, Shijiazhuang Second Hospital, Shijiazhuang 050200, Hebei Province, China
Hong Ye, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Author contributions: Ye H designed the report; He XY collected the patient’s clinical data; Liang JJ analyzed the data and wrote the paper.
Supported by Young Teacher Foundation of Wuhan University, China, No. 2042017kf0142; and Guidance Fund of Renmin Hospital of Wuhan University, China, No. RMYD2018M19.
Informed consent statement: Consent was obtained from relatives of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hong Ye, MD, Attending Doctor, Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Beijing 100053, China. chris_yehong@126.com
Telephone: +86-10-83198899 Fax: +86-10-63131271
Received: October 31, 2018
Peer-review started: October 31, 2018
First decision: December 9, 2018
Revised: December 22, 2018
Accepted: January 3, 2019
Article in press: January 3, 2019
Published online: February 26, 2019
Processing time: 118 Days and 19 Hours
Abstract
BACKGROUND

Listeria monocytogenes (L. monocytogenes), a Gram-positive facultatively intracellular bacterium, is the causative agent of human listeriosis. Listeria infection is usually found in immunocompromised patients, including elderly people, pregnant women, and newborns, whereas it is rare in healthy people. L. monocytogenes may cause meningitis, meningoencephalitis, and some very rare and severe complications, such as hydrocephalus and intracranial hemorrhage, which cause high mortality and morbidity worldwide. Up to now, reports on hydrocephalus and intracranial hemorrhage due to L. monocytogenes are few.

CASE SUMMARY

We herein report a case of rhombencephalitis caused by L. monocytogenes in a 29-year-old man. He was admitted to the hospital with a 2-d history of headache and fever. He consumed unpasteurized cooked beef two days before appearance. His medical history included type 2 diabetes mellitus, and contaminated beef intake 2 d before onset. Cerebrospinal fluid analysis revealed Gram-positive rod infection, and blood culture was positive for L. monocytogenes. Magnetic resonance imaging findings suggested rhombencephalitis and hydrocephalus. Treatment was started empirically and then modified according to the blood culture results. Repeated CT images were suggestive of intracranial hemorrhage. Although the patient underwent aggressive external ventricular drainage, he died of a continuing deterioration of intracranial conditions.

CONCLUSION

Hydrocephalus, intracranial hemorrhage, and inappropriate antimicrobial treatment are the determinations of unfavorable outcomes.

Keywords: Rhombencephalitis; Listeria monocytogenes; Central nervous system infections; Hydrocephalus; Intracranial hemorrhage; Case report

Core tip: Listeria monocytogenes (L. monocytogenes) infection occurs predominantly in immunocompromised subjects. Various manifestations of listeriosis have been reported previously, but hydrocephalus and intracranial hemorrhage due to Listeria are rare. Hydrocephalus, intracranial hemorrhage, and inappropriate antimicrobial treatment are determinants of unfavorable outcomes. A pertinent literature review might contribute to improving our understanding of the pathogenesis and treatment of this disease.