Listerial brain abscess in long-standing sarcoidosis.

A 50-year-old black man with steroid-dependent stage IV sarcoidosis and a prior seizure attributed to neurosarcoidosis had progressive disorientation, ataxia, cranial neuropathies, and increased dyspnea. Neuroradiologic evaluation showed a ring-enhancing lesion in the left basal ganglion causing a mass effect. Craniotomy yielded purulent material that grew a pure culture of Listeria monocytogenes. He responded well to antibiotic therapy.