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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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Autores principales: Tiri, Beatrice, Priante, Giulia, Saraca, Lavinia Maria, Martella, Lucia Assunta, Cappanera, Stefano, Francisci, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081550/
https://www.ncbi.nlm.nih.gov/pubmed/30140475
http://dx.doi.org/10.1155/2018/6549496
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author Tiri, Beatrice
Priante, Giulia
Saraca, Lavinia Maria
Martella, Lucia Assunta
Cappanera, Stefano
Francisci, Daniela
author_facet Tiri, Beatrice
Priante, Giulia
Saraca, Lavinia Maria
Martella, Lucia Assunta
Cappanera, Stefano
Francisci, Daniela
author_sort Tiri, Beatrice
collection PubMed
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.
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spelling pubmed-60815502018-08-23 Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review Tiri, Beatrice Priante, Giulia Saraca, Lavinia Maria Martella, Lucia Assunta Cappanera, Stefano Francisci, Daniela Case Rep Infect Dis Case Report 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. Hindawi 2018-07-24 /pmc/articles/PMC6081550/ /pubmed/30140475 http://dx.doi.org/10.1155/2018/6549496 Text en Copyright © 2018 Beatrice Tiri et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Tiri, Beatrice
Priante, Giulia
Saraca, Lavinia Maria
Martella, Lucia Assunta
Cappanera, Stefano
Francisci, Daniela
Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review
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
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081550/
https://www.ncbi.nlm.nih.gov/pubmed/30140475
http://dx.doi.org/10.1155/2018/6549496
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