Concurrent Diagnosis of Listeria Monocytogenes MeningoEncephalitis and Glioblastoma: Case Report and Review of the Literature

James Dimou and John Kelly

Department of Neurosurgery, University of Calgary, Canada

^*Correspondance to: John Kelly 

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Abstract:

Glioblastoma is the most common primary brain tumour in adults, with a poor prognosis in spite of maximal safe resection, and concomitant chemo irradiation. Confusion in the pre-operative setting of these patients is usually attributed to tumour progression or worsening mass effect, but other reversible causes also need to be excluded, especially when steroids have been commenced. We describe the case of a 66-year-old woman, found to have a ~3 cm peripherally enhancing right precentral gyrus lesion on CT and MRI, who developed acute fever and confusion as a neurosurgical inpatient almost two months after presenting symptoms of mild left face and upper limb weakness first began. Eventually requiring intubation and ventilator support follow up imaging demonstrated progressive hydrocephalus but little lesional change. As part of a comprehensive septic screen, cultures of cerebrospinal fluid, obtained via lumbar puncture and ventricular catheterization, revealed positive growth for Listeria monocytogenes, whilst a stereotactic needle biopsy of the lesion confirmed IDH-wild type glioblastoma and negative bacterial growth. Although the patient initially responded to intravenous antibiotic therapy and full supportive care including tracheostomy, palliative measures were institute dafter she was left fully dependent for her care needs, and she succumbed three months later without receiving adjuvant glioblastoma treatment. This case illustrates the need for vigilance in detecting treatable causes of confusion in this immune compromised patient group.

Keywords:

Glioblastoma; Listeria monocytogenes; Meningitis; Encephalitis; Infection; Cerebral abscess

Cite the Article:

Dimou J, Kelly J. Concurrent Diagnosis of Listeria Monocytogenes MeningoEncephalitis and Glioblastoma: Case Report and Review of the Literature. Clin Oncol. 2018; 3: 1547.