Synonyms:

Listeria brainstem encephalitis, neurolisteriosis, Listeria meningitis if without parenchymal involvement

Diagnosis:

• Positive CSF gram stain & culture: gram positive bacillus, Listeria monocytogenes
• Or Positive blood culture: growing Listeria monocytogenes
• Listeria meningitis if without parenchymal involvement

Clinical features:

• Fever +headache, then brainstem signs, then coma & respiratory failure

Findings on Investigations:

MRI:

• lesion in brainstem (pons & medulla). T2 hyperintense lesion. T1 plus contrast small ring enhancing.

CT: usually normal
CSF analysis:

• Lymphocytic pleocytosis (Polymorphonuclear PMN pleocytosis may occur), raised protein, normal glucose

Treatment:

• Ampicillin
• Sometimes combined with aminoglycoside e.g. gentamicin