Conglomerate ring and tract-like enhancement lesions: Neuroimaging in Listeria monocytogenes brain abscess

This report aims to describe a characteristic neuroimaging of Listeria monocytogenes brain abscess in predisposed patients. A 56-year-old man presented with fever and headache for 3 weeks. Cerebrospinal fluid (CSF) revealed pleocytosis with lymphocytosis, high protein, and low glucose. Both hemoculture and CSF culture yielded L monocytogenes. Another case is a 23-year-old woman with systemic lupus erythematosus, who presented with fever, headache and left hemiparesis. CSF showed pleocytosis with polymorphonuclear cells predominance and low glucose. Hemoculture positive for L monocytogenes. Their MRI brain revealed conglomerate ring and tract-like enhancement lesions at the right parietotemporal lobe. The patients were diagnosed with L monocytogenes brain abscess. They received a high dose of ceftriaxone and ampicillin for 6 weeks. The clinical and MRI at the end of treatment was a substantial improvement. Our information can help the physician concern about this pathogen in patients who presented with brain abscess and had these MRI findings.