Listeria monocytogenes Brain Abscess within a Metastatic Intracerebellar Space-Occupying Lesion in a Patient with Carcinoma Lung: First Case Report from India

Abstract

Listeria monocytogenes infections are rare. Neonates and geriatric population, pregnant women, and diabetic and immunocompromised patients are at higher risk for invasive listeriosis. Early recognition of Listeria brain abscess remains a major challenge. Here, we describe a case of intratumoral abscess with L. monocytogenes in a patient with intracerebellar metastasis from poorly differentiated adenocarcinoma lung. Right cerebellar tumor with a thick-walled purulent cavity was resected. Histopathologic examination revealed acute inflammation consistent with abscess and showed metastatic poorly differentiated adenocarcinoma. Cultures of the abscess fluid grew L. monocytogenes. She responded well to ampicillin-gentamycin therapy and the surveillance imaging done on the seventh postoperative day showed clearance of the abscess. The patient is further being planned for radiotherapy in regard to metastasis. Listeria abscess within a metastatic tumor is very rare and only one case is reported as of our knowledge. Listeria abscess being reported within an intracerebellar metastatic space-occupying lesion is for the first time.

Keywords

Listeria monocytogenes brain abscess - brain abscess within a metastasis - intracerebellar brain abscess

Funding

The authors have no financial relationships relevant to this article to disclose.

• References

• 1 Bartt R. Listeria and atypical presentations of Listeria in the central nervous system. Semin Neurol 2000; 20 (03) 361-373
• 2 Castro A, Hernández OH, Uribe CS, Guerra A, Urueña P. [Brainstem encephalitis and myelitis due to Listeria monocytogenes: a case report and literature review] [in Spanish]. Biomedica 2013; 33 (03) 343-349
• 3 Vázquez-Boland JA, Kuhn M, Berche P. , et al. Listeria pathogenesis and molecular virulence determinants. Clin Microbiol Rev 2001; 14 (03) 584-640
• 4 Lorber B. Listeria monocytogenes. . In: Bennett J, Dolin R, Blaser M. , eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier/Saunders; 2015: 2383-2390
• 5 National Center for Emerging and Zoonotic Infectious Diseases. Division of food borne, water borne and environmental diseases. CDC 24/7. Saving lives, protecting people. Centers for Disease Control and Prevention; March 24, 2015
• 6 Dalton CB, Austin CC, Sobel J. , et al. An outbreak of gastroenteritis and fever due to Listeria monocytogenes in milk. N Engl J Med 1997; 336 (02) 100-105
• 7 Prasad KN, Mishra AM, Gupta D, Husain N, Husain M, Gupta RK. Analysis of microbial etiology and mortality in patients with brain abscess. J Infect 2006; 53 (04) 221-227
• 8 Tattevin P, Bruneel F, Clair B. , et al. Bacterial brain abscesses: a retrospective study of 94 patients admitted to an intensive care unit (1980 to 1999). Am J Med 2003; 115 (02) 143-146
• 9 Stöve S, Feldmann A, Bäsecke J. [Cerebral listeria abscess in a patient with gastric cancer] [in German]. Dtsch Med Wochenschr 2013; 138 (14) 737-739
• 10 Drevets DA, Bronze MS. Listeria monocytogenes: epidemiology, human disease, and mechanisms of brain invasion. FEMS Immunol Med Microbiol 2008; 53 (02) 151-165
• 11 Duygulu G, Ovali GY, Calli C. , et al. Intracerebral metastasis showing restricted diffusion: correlation with histopathologic findings. Eur J Radiol 2010; 74 (01) 117-120
• 12 Hartmann M, Jansen O, Heiland S, Sommer C, Münkel K, Sartor K. Restricted diffusion within ring enhancement is not pathognomonic for brain abscess. AJNR Am J Neuroradiol 2001; 22 (09) 1738-1742
• 13 Eckburg PB, Montoya JG, Vosti KL. Brain abscess due to Listeria monocytogenes: five cases and a review of the literature. Medicine (Baltimore) 2001; 80 (04) 223-235
• 14 Toh CH, Wei KC, Chang CN, Ng SH, Wong HF, Lin CP. Differentiation of brain abscesses from glioblastomas and metastatic brain tumors: comparisons of diagnostic performance of dynamic susceptibility contrast-enhanced perfusion MR imaging before and after mathematic contrast leakage correction. PLoS One 2014; 9 (10) e109172
• 15 Kamble RB, Jayakumar PN, Shivashankar R. Role of dynamic CT perfusion study in evaluating various intracranial space-occupying lesions. Indian J Radiol Imaging 2015; 25 (02) 162-166
• 16 Skogberg K, Syrjänen J, Jahkola M. , et al. Clinical presentation and outcome of listeriosis in patients with and without immunosuppressive therapy. Clin Infect Dis 1992; 14 (04) 815-821
• 17 Goulet V, Hebert M, Hedberg C. , et al. Incidence of listeriosis and related mortality among groups at risk of acquiring listeriosis. Clin Infect Dis 2012; 54 (05) 652-660
• 18 Cone LA, Leung MM, Byrd RG, Annunziata GM, Lam RY, Herman BK. Multiple cerebral abscesses because of Listeria monocytogenes: three case reports and a literature review of supratentorial listerial brain abscess(es). Surg Neurol 2003; 59 (04) 320-328
• 19 Soares-Fernandes JP, Beleza P, Cerqueira JJ. , et al. Simultaneous supratentorial and brainstem abscesses due to Listeria monocytogenes . J Neuroradiol 2008; 35 (03) 173-176
• 20 Hof H, Nichterlein T, Kretschmar M. Management of listeriosis. Clin Microbiol Rev 1997; 10 (02) 345-357
• 21 Rodriguez RE, Valero V, Watanakunakorn C. Salmonella focal intracranial infections: review of the world literature (1884–1984) and report of an unusual case. Rev Infect Dis 1986; 8 (01) 31-41
• 22 Ng WP, Lozano A. Abscess within a brain metastasis. Can J Neurol Sci 1996; 23 (04) 300-302
• 23 Kovacic S, Bunc G, Krajnc I. Abscess formation within cerebellar metastatic carcinoma—report of two cases and review of the literature. Wien Klin Wochenschr 2004; 116 (Suppl. 02) 60-63
• 24 Moiyadi A, Shetty P. Abscess in a metastasis. J Neurosurg 2010; 112 (02) 474-475
• 25 Goto Y, Ebisu T, Mineura K. Abscess formation within a cerebellar metastasis: case report and literature review. Int J Surg Case Rep 2015; 10: 59-64