Listeria monocytogenes Brain Abscess

Listeria monocytogenes is a Gram-positive bacilli that exhibits predilection to infect the central nervous system in immunocompromised individuals, especially those with hematologic malignancy, immunosuppressive agents use including corticosteroid, diabetes mellitus, and HIV infection. The most common manifestations include meningitis and rhombencephalitis, but brain abscess occurs rarely. Therefore, L. monocytogenes may not be listed as a possible etiologic agent of brain abscess and this could result in treatment failure because ampicillin is usually not a drug of choice for empirical treatment. Blood culture and brain imaging seem to play a crucial role in making an early diagnosis of listerial brain abscess. There has been no controlled trial to establish a drug of choice or duration of therapy for listerial brain abscess. In this article, the authors aim to review the microbiology, pathogenesis, diagnosis, and management of listerial brain abscess. (J Infect Dis Antimicrob Agents 2013;30:91-100.)