Successful Weaning After Plasmapheresis Performed in a Patient with Myasthenic Crisis Provoked by Listeria Meningoencephalitis

Infection due to Listeria monocytogenes mostly effects immunocompromized hosts (1,2). Although, viruses usually cause encephalitis and bacterial infections are associated with meningeal inflammation, Listeria monocytogenes is one of the few bacterial microorganisms that may present as a meningoencephalitis and most frequently as a rhombencephalitis (1,2). Listeria rhombencephalitis causes respiratory failure in 41% of the cases, most probably due to the involvement of autonomic respiratory centers (1,2). Here we report a case of listeria meningoencephalitis without brainstem involvement provoking myasthenic crisis, acute hypercapnic respiratory failure and difficulty in weaning from the mechanical ventilation in a patient with myasthenia gravis. To the best of our knowledge, two cases of listeria meningitis in myasthenia gravis were reported previously (3), and this is the first report of listeria meningoencephalitis in a myasthenic patient.