Fever and temporal headache in a 70-year-old male with presumed large vessels vasculitis

Mediterranean Journal of Rheumatology

ARTICLE

Christos Vettas¹  Athina Dimosiari¹  Christina Kydona¹  Athina Pyrpasopoulou²  Eugenia Avdelidou⁴  Emmanouil Roilidis⁵  Alexandros Garyfallos¹  Theodoros Dimitroulas¹ 

[1] Fourth Department of Internal Medicine, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki;Second Propedeutic Clinic of Internal Medicine, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki;Department of Infectious Diseases, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki;Department of Neurology, Hippokration University Hospital;Third Department of Paediatrics, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki

关键词: listerial infection of CNS;    listeriosis;    brain abscess;    cerebritis;   

DOI  :  10.31138/mjr.31.2.220

学科分类：社会科学、人文和艺术（综合）

来源: PCO Convin S.A.

【 摘 要 】

Background: Listeria monocytogenes is an opportunistic pathogen that causes severe infections of the Central Nervous System, such as meningitis or meningoencephalitis, and brain abscesses. Abscesses account for approximately 1-10% of CNS listerial infections and are observed in 1% of all listerial infections. Methods: We describe a case of 70-year-old male patient who had several admissions in different hospitals over the last 8 weeks. Results: He suffered from intermittent fever for over a month, recurrent episodes of headaches, disorientation and other neurological symptoms. His condition was misdiagnosed as giant cell arteritis and initially the patient was started on corticosteroids. MRI of the brain revealed the presence of multiple brain abscesses and the cerebrospinal fluid study confirmed the presence of Listeria Monocytogenes. The patient was started on ampicillin and he completed a 6 weeks’ course of treatment. Conclusions: This case emphasizes the need to include rare pathogens in the differential diagnosis when possible CNS infections are involved, as well as to show that in many cases some auto-immune diseases are overdiagnosed.

【 授权许可】

CC BY-NC