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Disorders of local immunity associated with diabetes, neuropathy, vascular disease and pressure lesions all contribute to the pathogenesis of diabetic foot lesions. Diabetic foot infections are frequently encountered, comprising multifactorial pathology and high morbidity and mortality rates. Microbiological sampling is indicated only when infection is suspected clinically, that is, when a lesion presents a minimum of two of the following six signs: erythema, heat, pain, tumefaction, induration or purulent discharge.

We report the case of a 81-year-old, immunocompromised Patient, admitted to our hospital with new-onset headaches and word-finding difficulties. The MRI of the brain revealed a temporal mass on the left with marginal contrast-enhancement. During the next days Listeria monocytogenes grew in the bloodcultures so that the diagnosis of a brain-abscess caused by Listeria was established. Due to the localisation, surgical drainage of the abscess was not possible, so that a prolonged antibiotic therapy lasting over 4.5 months was initiated. The MRI after therapy demonstrated no abscess persistence. Listeria mostly cause infections in the immunocompromised, elderly, newborn or pregnant host. Next to bacteraemia without a focus, CNS-invasion with meningitis, meningoencephalitis or less frequent abcess-formation (5-10%) is the most important manifestation.