Listeria monocytogenes Brain Abscess Mimicking Ischemic Stroke in an Immunocompromised Patient: A Case Report

Listeria monocytogenes ( L. monocytogenes ) is a Gram-positive bacillus that infects immunocompromised persons, neonates, pregnant women and, occasionally, previously healthy individuals. L. monocytogenes brain abscesses are particularly rare. We present a 62-year-old female on corticosteroid treatment due to a recent diagnosis of autoimmune hepatitis, who suddenly developed right hemiparesis mimicking a stroke. A brain computerized tomography (CT) scan revealed a brain abscess and the blood cultures drawn yielded L. monocytogenes. A conservative treatment without surgical intervention was selected. The patient was commenced on intravenous ampicillin and gentamicin and showed remarkable improvement. She was successfully discharged on oral amoxicillin with probenecid. Since the subsequent magnetic resonance imaging (MRI) study and CT scans exhibited reduction in the size of the abscess, the antimicrobial treatment was discontinued after a three-month period. The patient underwent regular follow-up visits with no signs of relapse.