e Listeria monocytogenes rhombencephalitis is a severe progressive disease despite a swift intrathecal immune response. Based on previous observations, we hypothesized that the disease progresses by intra-axonal spread within the central nervous system. To test this hypothesis, neuroanatomical mapping of lesions, immunofluorescence analysis, and electron microscopy were performed on brains of ruminants with naturally occurring rhombencephalitis. In addition, infection assays were performed in bovine brain cell cultures. Mapping of lesions revealed a consistent pattern with a preferential affection of certain nuclear areas and white matter tracts, indicating that Listeria monocytogenes spreads intra-axonally within the brain along interneuronal connections. These results were supported by immunofluorescence and ultrastructural data localizing Listeria monocytogenes inside axons and dendrites associated with networks of fibrillary structures consistent with actin tails. In vitro infection assays confirmed that bacteria were moving within axon-like processes by employing their actin tail machinery. Remarkably, in vivo, neutrophils invaded the axonal space and the axon itself, apparently by moving between split myelin lamellae of intact myelin sheaths. This intra-axonal invasion of neutrophils was associated with various stages of axonal degeneration and bacterial phagocytosis. Paradoxically, the ensuing adaxonal microabscesses appeared to provide new bacterial replication sites, thus supporting further bacterial spread. In conclusion, intra-axonal bacterial migration and possibly also the innate immune response play an important role in the intracerebral spread of the agent and hence the progression of listeric rhombencephalitis.
Due to its resistance to hostile conditions, the Gram-positive bacterium Listeria monocytogenes is ubiquitously distributed in the environment and commonly contaminates food and animal feed (1-3). Upon oral uptake, L. monocytogenes may turn into an intracellular pathogen causing listeriosis, one of the deadliest foodborne infections in humans and ruminants (1,(4)(5)(6). Clinical syndromes associated with L. monocytogenes infection include febrile gastroenteritis, mastitis, septicemia, abortion, and central nervous system (CNS) infection, the latter accounting for the high mortality rates associated with listeriosis (1, 5-9). In most human patients, neurolisteriosis manifests as meningitis or meningoencephalitis, and L. monocytogenes is listed among the most common pathogens of bacterial meningitis (10-13). Further forms of neurolisteriosis include brainstem encephalitis (rhombencephalitis) occurring in 25% of cases and brain abscesses accounting for a further 10% of cases with CNS infection (11,14). Neurolisteriosis in ruminants occurs almost exclusively as rhombencephalitis (1, 15-17) and mimics its human counterpart in many respects (17, 18), lending itself as a spontaneous animal model.Although the intracellular life cycle of L. monocytogenes has been elegantly deciphered by in vitro st...