[Cerebral listeria abscess in a patient with gastric cancer].

UNLABELLED: HISTORY AND PRESENTATION ON ADMISSION: A 70-year-old woman with a history of gastric cancer and palliative chemotherapy was admitted with disturbed consciousness.

INVESTIGATIONS: The cranial CT showed a tumor in the left parietocccipital region so that a cerebral metastasis was suspected. However further investigations including cranial MRT, liquor and blood culture collection showed that the immunocompromised patient suffered from a Listeria monocytogenes sepsis with subsequent meningitis and a cerebral abscess.

TREATMENT AND COURSE: During an antibiotic treatment with ampicillin and gentamycin a rapid neurological improvement and normalization of the liquor findings was achieved.

CONCLUSIONS

Listeria monocytogenes is a rare but relevant cause of systemic inflammations in immunocompromised patients. The differentiation between cerebral abscess and metastasis in cancer patients can be complex but is important concerning differential therapeutic approaches.