Romboencefalitis: una forma de infección por Listeria monocytogenes en el sistema nervioso central

Listeria monocytogenes infections can involve the central nervoussystem in the form of a rhomboencephalitis. Three possible cases of rhomboencephalitis byListeria 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 inabsence of a meningeal syndrome. The neurological stage was defined by the unilateralinvolvement of cranial nerves and the cerebellum and a clear inflammatory cerebrospinal fluid(CSF) with the presence of polymorphonuclear leukocytes, and normal glucose and proteinlevels. A magnetic nuclear resonance (MRI) showed the appearance of characteristic images,present in the bulboprotuberancial region. These images are one of the most constant features ofthis disease, reported in the literature. The early diagnosis of rhomboencephalitis was based onthe clinical picture, the study of the CSF and the MRI, allowing the use of antimicrobials, priorto microbiological identification. Therefore, the risk of brain stem and cardiac complications ofthe disease is reduced (Rev Med Chile 2003; 131: 921-8).(