Listeria brain abscesses during administration of mycophenolate mofetil for systemic lupus erythematosus: a case report

Serial magnetic resonance imaging findings of intracerebral spread of listeria utilising subcortical U-fibres and the extreme capsule

“…Invasive listeriosis occurs more commonly in immunocompromised individuals, and known risk factors include: diabetes mellitus, chronic illness, pregnancy, extremes of age (neonates and the elderly), immunosuppressive medications and solid-organ or haematologic malignancies. 1–3,5–7 L. monocytogenes has a striking predilection for CNS invasion, and this is particularly prevalent in neonates and the elderly, in whom it is the second leading cause of bacterial meningitis. 1–3 CNS manifestations of listerosis depend on the intracranial compartment affected and include meningitis, encephalitis, rhombencephalitis, meningoencephalitis and less commonly cerebral abscess.…”

“…1–3 CNS manifestations of listerosis depend on the intracranial compartment affected and include meningitis, encephalitis, rhombencephalitis, meningoencephalitis and less commonly cerebral abscess. 1–3,5,6,8 The distribution of brain abscesses in listerosis follows a unique pattern, and is usually observed in the reticular formation of the midbrain, pons and medulla and to lesser extent the supratentorial brain. 3,6,8,9 The predilection for brainstem involvement is likely attributed to retrograde neuronal spread of infection spread via the trigeminal nerve whereas supratentorial brain involvement is likely from hematogenous seeding.…”

Multiple brain abscesses due to Listeria monocytogenes infection in a patient with systemic lupus erythematosus: A case report and literature review

“…9 without sequelae, and 3 patients survived with residual neurological sequelae. 23,26,29 The mortality rate in this group is as high as 37.2%.…”

“…9,34 As few as 6 cases have been reported, with 4 involving multiple brain abscesses (Table 3). 12,17,25,26,29,33 Among the 52 cases reported in the literature, the treatment scheme of SLE at onset was provided for 32. Twenty-nine patients were receiving high to moderate doses of corticosteroids combined with/or immunosuppressants, including azathioprine, CYC, mofetil mycophenolate, methotrexate and cyclosporine.…”

The role of infections in neuropsychiatric lupus

“…Brain abscess is usually solitary and typical locations are pons, thalamus and medulla. 31 Listeria encephalitis can mimic herpes simplex infection, since both can cause hemorrhagic CSF. 30,32 The presence of diarrhea along with neurologic clinical findings can be a diagnostic clue for LM diagnosis.…”