Brain abscess due to Listeria monocytogenes: first case report in Thailand.

Authors

Treebupachatsakul P, Srifeungfung S, Chayakulkeeree M

Institution

Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Source

J Med Assoc Thai 2006 Sep; 89(9) :1516-20.

Abstract

Brain abscess with bacteremia caused by Listeria monocytogenes in a young woman with immune thrombocytopenic purpura was reported. The clinical features included fever, headache, and left-side weakness. Computed tomography and magnetic resonance imaging of the brain showed a large single abscess at the right frontoparietal area. L. monocytogenes was isolated from a blood culture. The patient promptly received a surgical drainage. Because she had a history of penicillin allergy, and the organism was resistant to ampicillin, she was treated with trimethoprim-sulfamethoxazole (TMP-SMX) alone for 12 months. During a one-year follow-up period, the patient improved and her neurological deficit gradually recovered. This is the first case of listerial brain abscess in Thailand that was successfully treated with TMP-SMX monotherapy and surgical drainage.