The learning objective of this educational exhibit is to focus on unusual presentation of CNS Neurolisteriosis,
starting from the neuroradiological framework,
compatible with an inflammatory-infectious process involving the brain and cervical spinal cord,
with granulomatous appearance,
evaluating different MR appearance and possible differential diagnosis.
Listeria monocytogenes is a Gram + bacterium,
facultative anaerobic; it proliferates in a wide range of pH and temperature (between 0 ° C and + 45 ° C) also in the refrigerator.
Infection takes place after ingestion of contaminated food,
primarily unpasteurized dairy products and undercooked vegetables,
but also raw meat and fish .
Listeria infections are more common in the summer.
Pregnant women are at greater risk for maternal-fetal infection.
Gastroenteritis commonly happens after an average incubation time of 24 hours (range 6 hours...
Findings and procedure details
We reviewed MR imaging appearance and medical records of patients with an unusual presentation of CNS neurolisteriosis managed at our hospital with challenging features and clinical course.
Rhomboencephalitis: uncommon neural pathway,
a solution of the oral mucosa is penetration site.
Therefore Listeria can invade the nerve fibers transcellularly and migrate in a retrograde way (transcellular and intra-axonal) along the cranial nerves branches,
in particular the V cranial nerve (V-CN).
Once brainstem reticular formation is reached,
usually the trigeminal sensory nuclei,
from here the diffusion along...
We observed rare cases of rhomboencephalitis with peculiar and repetitive characteristics that include foci of enhancement and involvement of the V cranial nerve and of the medulla and spinal cord with a typical recurrent pattern,
while the described cases of meningoencephalitis,
were characterized by less specific aspects.
These observations reinforce the concept that MR peculiar findings identification in infectious diseases is crucial in the diagnostic process.
Simonetta Gerevini,Neuroradiology Department- IRCCSOspedale San Raffaele - Via Olgettina 60,
20132 Milano - Italy; firstname.lastname@example.org
Mariangela Cava,Radiology Department - Ospedale San Giacomo - 15067Novi Ligure (AL) - Italy; email@example.com
Maurizio Barbera,Radiology-Neuroradiology Department Resident - IRCCSOspedale San Raffaele - Via Olgettina 60,
20132 Milano - Italy; firstname.lastname@example.org
Andrea Falini,Head of Neuroradiology Department - IRCCSOspedale San Raffaele - Via Olgettina 60,
20132 Milano - Italy
Angela Genchi,Neurology Department - IRCCSOspedale San Raffaele - Via...
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