Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review
Listeria monocytogenes (LM) is an opportunistic pathogen, and the most common central nervous system manifestation is meningitis while listerial brain abscesses are rare. We describe 2 cases of brain abscess due to LM and a literature review. Only 73 cases were reported in the literature from 1968 t...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2018/6549496 |
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| author | Beatrice Tiri Giulia Priante Lavinia Maria Saraca Lucia Assunta Martella Stefano Cappanera Daniela Francisci |
| author_facet | Beatrice Tiri Giulia Priante Lavinia Maria Saraca Lucia Assunta Martella Stefano Cappanera Daniela Francisci |
| author_sort | Beatrice Tiri |
| collection | DOAJ |
| description | Listeria monocytogenes (LM) is an opportunistic pathogen, and the most common central nervous system manifestation is meningitis while listerial brain abscesses are rare. We describe 2 cases of brain abscess due to LM and a literature review. Only 73 cases were reported in the literature from 1968 to 2017. The mean age was 51.9, and the mortality rate was 27.3%. In 19% of cases, no risk factors for neurolisteriosis were identified. Blood cultures were positive in 79.5% while CSF or brain abscess biopsy material was positive in 50.8%. In 40% was started a monotherapy regimen while in 60% a combination therapy without substantial differences in mortality. Fifty-two percent underwent neurosurgery while 45.3% has been treated only with medical therapy. The mortality rates were, respectively, 13% and 38.2%. Only 25% of patients who were treated for ≤6 weeks underwent neurosurgery, while 80% of those who were treated for ≥8 weeks were operated. The mortality rates were, respectively, 12.5% and 0%, suggesting that a combined approach of surgery and prolonged medical therapy would have an impact on mortality. We believe that it is essential to carry out this review as brain abscesses are rare, and there are no definitive indications on the optimal management, type, and duration of therapy. |
| format | Article |
| id | doaj-art-dd66f4237e6c4d1ca64705c8c150bc25 |
| institution | OA Journals |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-dd66f4237e6c4d1ca64705c8c150bc252025-08-20T02:21:30ZengWileyCase Reports in Infectious Diseases2090-66252090-66332018-01-01201810.1155/2018/65494966549496Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature ReviewBeatrice Tiri0Giulia Priante1Lavinia Maria Saraca2Lucia Assunta Martella3Stefano Cappanera4Daniela Francisci5Infectious Diseases Clinic, Department of Medicine, University of Perugia, Perugia, ItalyInfectious Diseases Clinic, Department of Medicine, University of Perugia, Perugia, ItalyInfectious Diseases Clinic, Department of Medicine, University of Perugia, Perugia, ItalyInfectious Diseases Clinic, Department of Medicine, “S. Maria” Hospital, Terni, ItalyInfectious Diseases Clinic, Department of Medicine, “S. Maria” Hospital, Terni, ItalyInfectious Diseases Clinic, Department of Medicine, University of Perugia, Perugia, ItalyListeria monocytogenes (LM) is an opportunistic pathogen, and the most common central nervous system manifestation is meningitis while listerial brain abscesses are rare. We describe 2 cases of brain abscess due to LM and a literature review. Only 73 cases were reported in the literature from 1968 to 2017. The mean age was 51.9, and the mortality rate was 27.3%. In 19% of cases, no risk factors for neurolisteriosis were identified. Blood cultures were positive in 79.5% while CSF or brain abscess biopsy material was positive in 50.8%. In 40% was started a monotherapy regimen while in 60% a combination therapy without substantial differences in mortality. Fifty-two percent underwent neurosurgery while 45.3% has been treated only with medical therapy. The mortality rates were, respectively, 13% and 38.2%. Only 25% of patients who were treated for ≤6 weeks underwent neurosurgery, while 80% of those who were treated for ≥8 weeks were operated. The mortality rates were, respectively, 12.5% and 0%, suggesting that a combined approach of surgery and prolonged medical therapy would have an impact on mortality. We believe that it is essential to carry out this review as brain abscesses are rare, and there are no definitive indications on the optimal management, type, and duration of therapy.http://dx.doi.org/10.1155/2018/6549496 |
| spellingShingle | Beatrice Tiri Giulia Priante Lavinia Maria Saraca Lucia Assunta Martella Stefano Cappanera Daniela Francisci Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review Case Reports in Infectious Diseases |
| title | Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review |
| title_full | Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review |
| title_fullStr | Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review |
| title_full_unstemmed | Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review |
| title_short | Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review |
| title_sort | listeria monocytogenes brain abscess controversial issues for the treatment two cases and literature review |
| url | http://dx.doi.org/10.1155/2018/6549496 |
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