A 16 Year-Old Girl with Fever, Abdominal Pain and Progressive Neurological Deficits
نویسندگان
چکیده
Introduction: Listeria monocytogenes is a small gram positive bacillus that can be isolated from soil, vegetation or animal reservoirs. Human disease occurs mainly in immunocompromised people, neonates and in pregnancy while the cases in immunocompetent people are rare. CNS manifestations of the disease can be in form of meningitis, encephalitis and also cerebritis since L. monocytogenes shows tropism for brain and brain stem as well for the meninges. Case presentation: A 16 year-old girl, who had been previously healthy, came at our attention because of progressive neurological deficits. The symptoms of the disease were present two months before the admission when she had experienced intermittent and severe headaches and fever up to 38 C, nausea, vomiting and abdominal pain lasting for 5 days. Her symptoms included lethargy and pain at the moment of admission. After having developed diplopia and unsteady gait after three weeks she was admitted in our department. Multiple cranial neuropathies were present. Neurological diagnosis was rhombencephalitis. CSF analysis showed a colorless fluid, 10 lymphocytes/mm3, 77 mg/dl protein, and 69 mg/dl glucose. Serum samples obtained during the admission were positive for Listeria and she was treated with ampicillin and gentamicine accordingly, with a good immediate response. Conclusion: The most important feature of this paper is its extended differential diagnosis comprising tumoral, inflammatory, vascuar and infectious diseases. Thus, it represents a valuable aid for all concerned specialist of above-mentioned fields.
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Editor’s note: Each month, Case Challenge features a discussion of an unusual diagnosis. A description and images are presented, followed by the diagnosis and an explanation of how the diagnosis was determined. Your comments are welcome via email at [email protected]. To submit a case, visit: www.PediatricSuperSite.com/Submit. A 16-Year-Old Girl with Chronic Intermittent Abdominal Pain
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