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Maria Stavrou, Lucy Francis, Nomathamsanqa Tshuma, Klaus Schmierer
Rhomboencephalitis, at least in its acute phase, is often a severely disabling syndrome, and can be life threatening. A range of underlying conditions can lead to this clinical syndrome. Rapid diagnosis to initiate treatment early is key to a beneficial outcome. We report the case of a 22 year old Afro-Caribbean woman, who presented with a two -week history of walking difficulties, upper limb incoordination and slurred speech. Her brainstem function deteriorated at pace, and she developed hypersomnia. A broad diagnostic approach led to prophylactic treatment for the most common infectious causes...
May 23, 2018: BMJ Case Reports
La Von Ross, Nakita Barnes, Judson Lewis, Jenna Foster, William Owens
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Daniel S Atherton, Sarah R Perez, Nathan D Gundacker, Ricardo Franco, Xiaosi Han
Acute disseminated encephalomyelitis (ADEM) is a disease characterized by inflammation and destruction of myelin. Acute hemorrhagic leukoencephalitis (AHLE) is a severe form of ADEM known for its particularly poor outcome. We present a case of a young Caucasian female who presented with drowsiness and slurred speech followed by rapid brainstem involvement resembling rhomboencephalitis. Despite multiple diagnostic tests and empiric therapy with immunosuppressants, immunoglobulins, and antimicrobials, she lost most brainstem reflexes within a few weeks and ultimately passed away...
April 2016: Clinical Neurology and Neurosurgery
Cheryl Pz Foo, Andrew McDermid, Elsie Grudeski, Tim F Booth, Jared Bullard
No abstract text is available yet for this article.
September 2015: Canadian Journal of Infectious Diseases & Medical Microbiology
Bahareh Bazooyar
Brainstem involvement is a characteristic feature and accounts for the high mortality associated with listeriosis especially in immunosuppressed patients. We report two cases of rhombencephalitis infection by Listeria monocytogenes in a 65 and 63-year-old men with diabetes. They were referred to a neurologist due to fever and drowsiness after 3 weeks. The 65-year-old man had vertigo, diplopia, ataxia, bidirectional nystagmus and the 63-year-old man complained of perioral numbness, dysphagia and dysartheria...
September 2015: Archives of Iranian Medicine
Benji K Mathews, Charles Chuang, Ajay Rawal, Elie Gertner
We describe a case of an 87-year-old woman with rheumatoid arthritis on etanercept who developed subacute encephalopathy. Magnetic resonance imaging and blood cultures led to the diagnosis of Listeria monocytogenes rhomboencephalitis, which proved to be fatal. Postmortem examination of the brain revealed abscesses with extensive necrosis. Gram stain showed small gram-positive rods in the necrotic tissue and the wall lining the abscesses. While rhomboencephalitis is a rare entity, and clinical recognition may be hampered by immunosuppression such as in this case, early blood cultures, lumbar puncture, and empiric treatment with ampicillin should be initiated in all patients with suspected rhomboencephalitis if suggested by imaging and by a clinical concern for infection...
September 2014: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Vincenzo Belcastro, Mirko Piola, Sandro Binda, Domenico Santoro, Monica Rezzonico, Marco Arnaboldi
Opsoclonus-myoclonus syndrome (OMS) is characterized by opsoclonus and arrhythmic-action myoclonus that predominantly involves the trunk, limbs, and head. Human herpes virus-6 (HHV-6) can rarely cause encephalitis in immunocompetent children and adults. Here we report on a case of OMS associated with HHV-6 rhomboencephalitis. HHV-6 infection should be considered in OMS adults and detection of cell-free viral DNA, indicative of active infection, is mandatory in such cases.
June 15, 2014: Journal of the Neurological Sciences
Rocío Sedano, Alberto Fica, Dannette Guiñez, Stephanie Braun, Lorena Porte, Jeannette Dabanch, Thomas Weitzel, Andrés Soto
BACKGROUND: Listeria monocytogenes infections have been poorly characterized in Chile. AIM: To evaluate clinical manifestations and risk factors associated to a fatal outcome in a series of patients. METHODS: retrospective analysis of cases from 1991 to 2012. RESULTS: Twenty three cases were identified, including 2 diagnosed after prolonged hospitalization (8.7%) with an average age of 68.4 years (range 44-90). Known predisposing factors were age > 65 years (60...
August 2013: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Francesco Ruggieri, Marco Cerri, Luigi Beretta
Here we originally describe the clinical scenario of a young immune-competent patient affected by acute rhomboencephalitis with severe parenchymal edema and acute hydrocephalus who developed sudden life-threatening cardiac derangement. Hemodynamic and perfusion parameters revealed cardiogenic shock, so intensive circulatory support with epinephrine infusion and intra-aortic balloon pump was needed to restore organ perfusion. Transesophageal echocardiographic examination showed severe left ventricular dysfunction (ejection fraction as low as 20%) with wall motion abnormalities resembling a pattern of Takotsubo-inverted cardiomyopathy...
February 2014: American Journal of Emergency Medicine
Raúl Carrillo-Esper, Luis Daniel Carrillo-Cordova, Isis Espinoza de los Monteros-Estrada, Agustín Omar Rosales-Gutiérrez, Misael Uribe, Nahum Méndez-Sánchez
We report a case of rhombencephalitis infection by Listeria monocytogenes in a 66-year-old man with cirrhosis. The CSF analysis indicated L. monocytogenes as the most likely pathogen. Blood and CSF culture were positive to L. monocytogenes and MRI findings were suggestive of rhomboencephalitis. The treatment was started empirically and then modified when the culture results were available. The patient had a full clinical recovery without neurologic sequelae. Clinicians should remember that L. monocytogenes most often presents as acute bacterial meningitis, particularly in the elderly, the immunosuppressed, and those with malignancies...
September 2013: Annals of Hepatology
S Workman, M Theal
Listerial rhomboencephalitis is a rare, devastating treatable disease. A previously well 72-year-old man presented with a one-week history of fever and headache. Four days before admission he developed right facial numbness and ataxia. Diagnosis and treatment are described, including the relevant clinical, laboratory and radiological findings.
March 1997: Canadian Journal of Infectious Diseases, Journal Canadien des Maladies Infectieuses
Adam Abbs, Tp Nandakumar, Pyari Bose, Dalila Mooraby
No abstract text is available yet for this article.
April 2012: Practical Neurology
Tanya Pereira, Claudia P Rojas, Monica T Garcia-Buitrago, Jayanthi Chandar, Carolyn Abitbol, Wacharee Seeherunvong, Paolo Rusconi, Jocelyn H Bruce, Gaston Zilleruelò
In this report, we describe the development of BKVN in the native kidneys of a child with a cardiac transplant. Elevated BK viral DNA load by PCR necessitated a prolonged course of treatment with escalating doses of cidofovir. Despite a reduction in plasma BK viral load, the infection evolved into an invasive CNS disease, resulting in rhomboencephalitis. This case highlights the need for awareness of the possibility of developing multiorgan complications from BKV infection. The current treatment options for BKV tissue invasive disease are inadequate and need to be improved...
November 2012: Pediatric Transplantation
Mohamed Ramadan, Nicole M McGrath
No abstract text is available yet for this article.
October 14, 2011: New Zealand Medical Journal
Jordan S Dubow, Samuel Singer, Alan Z Segal
No abstract text is available yet for this article.
September 27, 2011: Neurology
Gonzalo Miranda González, Patricia Orellana P, Holvis Dellien Z, Margarita Switt R
An unusual number of cases of rhomb encephalitis have occurred in Chile because of the increased frequency of infections caused by Listeria monocytogenes. We report three females aged 36, 40 and 55 years, with the disease. All presented with a prodrome characterized by headache, nausea, vomiting and fever, followed by ataxia and unilateral palsies of the third, seventh and twelfth cranial nerves. One patient presented also a hemi-hypoesthesia. Magnetic resonance showed lesions in the posterior aspect of the brain stem, specifically in relation to the floor of the fourth ventricle...
December 2009: Revista Médica de Chile
D Ricard, M Sallansonnet-Froment, G Defuentes, T de Greslan, P Bounolleau, H Taillia, F Flocard, J-L Renard
INTRODUCTION: Listeriosis commonly involves the central nervous system. Meningoencephalitis and rhomboencephalitis are the most frequent manifestations. Brain abscesses are rare. CASE REPORT: We report the case of a 63-year-old man treated with steroids for a long period; he was hospitalized for hemiparesis, confusion and fever. Clinical examination revealed meningeal signs, right hemiparesis and Parinaud syndrome. Initial CT scan was normal. The CSF contained 520 white cells/mm3 with predominance of polymorphonuclear neutrophils...
April 2008: Revue Neurologique
Ronald Salamano, Adelina Braselli, Alicia Hoppe, Raquel Monteghirfo, Teresita Silva
INTRODUCTION: Listeria monocytogenes shows a special attraction to infect the central nervous system and its meningeals coats. It affects newborn as well as elderly people, patients with deficiencies in their cellular immune systems, and healthy adults. It presents most commonly as an acute meningitis, although it can present itself as cerebritis, brain stem encephalitis (rhomboencephalitis), and exceptionally as myelitis. PATIENTS: We describe six clinical cases of neurolisterioris, five of which in healthy adults; we also describe the images and cerebrospinal fluid (CSF) findings, RESULTS: Three patients contracted acute meningitis, one of them meningoencephalitis, one cerebritis and the last one rhomboencephalitis...
December 2005: Arquivos de Neuro-psiquiatria
Sergio Illanes, Pablo Araya, Sergio Ferrer, Luis Cartier, Mauricio Bravo, Sergio Castillo
Listeria monocytogenes infections can involve the central nervous system in the form of a rhomboencephalitis. Three possible cases of rhomboencephalitis by Listeria monocytogenes are reported (2 females, aged 44 and 49 and a man of 36 years old). The three cases were preceded by an unspecific prodrome of headache, vertigo and fever in absence of a meningeal syndrome. The neurological stage was defined by the unilateral involvement of cranial nerves and the cerebellum and a clear inflammatory cerebrospinal fluid (CSF) with the presence of polymorphonuclear leukocytes, and normal glucose and protein levels...
August 2003: Revista Médica de Chile
Richard T Johnson
New viral infections of the nervous system have been appearing with great regularity. Some result from the evolution of new agents and others from the entry of viruses into new hosts or environments. The emergence of neurovirulent enteroviruses causing a paralytic poliomyelitis syndrome and rhomboencephalitis represent the evolution of new human viruses. Most emerging viral infections represent movement of an agent into new geographic areas or across species barriers. The transport of neurovirulent strains of West Nile virus into the Western Hemisphere and the penetration of Nipah virus, a newly recognized paramyxovirus, across species barriers from bat to pig to man are examples that are highlighted in this review...
April 2003: Journal of Neurovirology
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