Rhomboencephalitis

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...

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No abstract text is available yet for this article.

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...

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...

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...

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...

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...

We describe a case of presumed listeria monocytogenes rhomboencephalitis, which was initially confused with leptomeningeal carcinomatosis in a patient with a malignant carcinoid tumor. Long-term corticosteroid treatment and immunosuppression caused by malignancy predisposed the patient to developing listeriosis. The clinical and radiologic features of this illustrative case are described. Listeriosis is an important treatable differential diagnosis in patients with malignancy presenting with neurologic signs...

Listeria monocytogenes infection of the central nervous system is often not recognized and treated appropriately in the crucial early stages of the disease. Most consider patients with underlying disease or immunocompromised states to be at risk, although healthy individuals may present with a neurologic syndrome caused by L. monocytogenes. Earlier suspicion and treatment remains our best means of reducing the morbidity and high mortality rate of this treatable disease. In addition to meningitis and meningoencephalitis, infection of the brainstem (rhomboencephalitis) is challenging to recognize and therefore initiate appropriate early therapy...

We report a previously healthy 44 years old female, that presented with mild clouding of consciousness, a left cerebellar syndrome, involvement of V, X and XII left cranial nerves and an alteration of epicritic sensitivity in the left half of the body. Cerebrospinal fluid had inflammatory features. Cerebrospinal fluid and blood cultures were positive for Listeria monocytogenes. Magnetic resonance imaging disclosed a rhomboencephalitis. Antibiotics were started and the clinical condition of the patient improved progressively...

Central nervous system infections due to Listeria monocytogenes result in a variety of clinical syndromes ranging from meningitis to rhomboencephalitis. We report the case of a previously healthy patient with rhomboencephalitis in whom the CT scan was normal, while magnetic resonance imaging (MRI) confirmed the diagnosis. We review the literature and emphasize the value of MRI for timely diagnosis.

Listeria monocytogenes rhomboencephalitis is an uncommon complication of L. monocytogenes meningitis. It presents in a typical biphasic pattern characterized by a non-specific prodromal period followed by any combination of asymmetrical, cranial-nerve palsies; cerebellar signs; hemiparesis or hypesthesia; and diminished consciousness. The survival rate is greater than 70% when appropriate antibiotic therapy is initiated early. However, approximately 60 percent of the survivors develop neurological sequelae...

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Listeria rhomboencephalitis is a rare form of listeriosis which is frequently not diagnosed before death. We here describe an instance in an apparently healthy immunocompetent lady which responded to appropriate therapy. Treatment with intravenous ampicillin with or without an aminoglycoside antibiotic should be instituted early if the patient is to survive.

Central nervous system infections with Listeria monocytogenes result in varied clinical syndromes ranging from meningitis to rhomboencephalitis. A case of Listeria meningitis complicated by symptomatic communicating hydrocephalus and hydrostatic cervical cord compression is presented which clinically and radiographically improved with aggressive ventricular drainage.

A previously healthy woman had a febrile illness resembling aseptic meningoencephalitis. With the exception of mild increase in both CSF pressure and protein concentration, initial findings were normal, including negative bacterial cultures. Bilateral pyramidal and cerebellar signs with multiple lower cranial nerve pareses developed over a 48-hour period beginning on the tenth hospital day. Repeated blood and CSF studies had previously been nondiagnostic, but at that time, cultures became positive for Listeria monocytogenes...