Adam E. Klein, MD - West Virginia State Medical Association

Scientific Article |Figure 1.Axial, contrast-enhanced MRI showingan irregular, ring-enhancing lesion in theleft parietal lobe.Figure 2.Hematoxylin and Eosin stained surgical specimen showing necrotic brain with anassociated neutrophilic inflammatory infiltrate.case, ninety percent of patients withlisterial abscesses were male. 2Presentation of patients is mostoften due to rapid onset of symptoms,with 88% of reported cases havingsymptoms for two weeks or less. 3This is consistent with our patient’scomplaints of gait difficulty for 1½weeks prior to presentation. Mosthave had fevers, and all have hadabnormal neurologic findings. 3Although our patient presented withclassic headaches suggesting anintracranial mass lesion, headachewas a less common presentingsymptom among patients withlisterial abscesses than in those withother brain abscesses. 3 It has beendemonstrated that blood culturesare more often positive in thesepatients than in other patients withbrain abscesses. 1,2,3,5 In one series,86% had positive blood cultures. 3Prognosis in these patients isguarded, with an approximately40% mortality rate attributed tothe infection. 2 Of the survivors,61% in previous series have hadresidual neurologic deficits. 3 Mostreported deaths due to listerialFigure 3.Hematoxylin and Eosin stained surgical specimen showing perivascular lympohcytesand loose microglial nodule formation14 West Virginia Medical Journal