Rhombencephalitis by Listeria Monocytogenes in an Immunocompetent Child

A previously healthy 21-month-old girl who presented to the emergency department with 4 days of fever and progressive lethargy, initially computed tomography (CT) scan was normal and the cerebrospinal fluid (CSF) was lymphocyte predominant pleocytosis. Despite medical treatment, she showed a progressive neurological worsening. A new CSF culture showed L. monocytogenes growing and a brain MRI demonstrated rhombencephalitis and secondary obstructive hydrocephalus. Meningoencephalitis by Listeria monocytogenes is a rare entity in immunocompetent toddlers and older children, rhombencephalitis is an unusual form of presentation, which affects the brain stem and protuberance parenchyma. With this case, we review the clinical presentation and management of this unusual infection.