Persistent Listeria monocytogenes Cerebritis Mimicking Cerebral Metastases Due to Melanoma.

Listeria cerebritis is a rare yet serious central nervous system infection, which can present with leptomeningeal enhancement, abscess, and seizures. An adult patient with a history of metastatic melanoma presented with left-sided weakness, later identified as postictal Todd's paralysis due to focal motor seizures. Further diagnostic workup revealed a leptomeningeal abscess in the setting of listeria cerebritis. The patient's condition improved after treatment with a prolonged course of ampicillin, gentamicin, and linezolid over eight weeks. Leptomeningeal disease in patients with cancer history is often thought to be metastatic disease but infections, such as listeria, should be considered even if cerebrospinal fluid is bland. Treatment of listeria may need to be prolonged in patients who are immunocompromised.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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