scholarly journals Listeria Monocytogenes Brain Abscesses in a Patient with Disseminated Non-Small Cellular Lung Cancer: MRI Findings

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1115
Author(s):  
Anders Lykkemark Simonsen ◽  
Nitesh Shekhrajka ◽  
Frederik Boëtius Hertz ◽  
Jannik Helweg-Larsen ◽  
Åse Bengård Andersen ◽  
...  

Brain abscesses caused by Listeria monocytogenes (LM) are very rare and carry a high mortality risk. We present a patient with disseminated non-small cellular lung cancer (NSCLC) and multiple unusual LM brain abscesses. These abscesses have multiple elongated peripherally enhancing lesions in a characteristic formation that is “worm or tramtrack-like” following the white matter fiber tracts.

2015 ◽  
Vol 123 (6) ◽  
pp. 1593-1599 ◽  
Author(s):  
Michel W. Bojanowski ◽  
Romuald Seizeur ◽  
Khaled Effendi ◽  
Patrick Bourgouin ◽  
Elsa Magro ◽  
...  

Animal studies have shown that Listeria monocytogenes can probably access the brain through a peripheral intraneural route, and it has been suggested that a similar process may occur in humans. However, thus far, its spreading through the central nervous system (CNS) has not been completely elucidated. The authors present a case of multiple L. monocytogenes cerebral abscesses characterized by a pattern of distribution that suggested spread along white matter fiber tracts and reviewed the literature to identify other cases for analysis. They elected to include only those cases with 3 or more cerebral abscesses to make sure that the distribution was not random, but rather followed a pattern. In addition, they included those cases with abscesses in both the brainstem and the cerebral hemispheres, but excluded cases in which abscesses were located solely in the brainstem. Of 77 cases of L. monocytogenes CNS abscesses found in the literature, 17 involved multiple abscesses. Of those, 6 were excluded for lack of imaging and 3 because they involved only the brainstem. Of the 8 remaining cases from the literature, one was a case of bilateral abscesses that did not follow a fiber tract; another was also bilateral, but with lesions appearing to follow fiber tracts on one side; and in the remaining 6, to which the authors added their own case for a total of 7, all the abscesses were located exclusively in the same hemisphere and distributed along white matter fiber tracts. The findings suggest that after entering the CNS, L. monocytogenes travels within the axons, resulting in a characteristic pattern of distribution of multiple abscesses along the white matter fiber tracts in the brain. This report is the first description suggesting intraaxonal CNS spread of L. monocytogenes infection in humans following its entry into the brain. This distinct pattern is clearly seen on imaging and its recognition may be valuable in the diagnosis of listeriosis. This finding may allow for earlier diagnosis, which may improve outcome.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 282.2-282
Author(s):  
S. Ruiz-Simón ◽  
I. Calabuig ◽  
M. Gomez-Garberi ◽  
M. Andrés

Background:We have recently revealed by active screening that about a third of gout cases in the cardiovascular population is not registered in records [1], highlighting the value of field studies.Objectives:To assess whether gout screening in patients hospitalized for cardiovascular events may also help identify patients at higher risk of mortality after discharge.Methods:A retrospective cohort field study, carried out in 266 patients admitted for cardiovascular events in the Cardiology, Neurology and Vascular Surgery units of a tertiary centre in Spain. The presence of gout was established by records review and face-to-face interview, according to the 2015 ACR/EULAR criteria. The occurrence of mortality during follow-up and its causes were obtained from electronic medical records. The association between gout and subsequent mortality was tested using Cox regression models. Whether covariates affect the gout-associated mortality was also studied.Results:Of 266 patients recruited at baseline, 17 were excluded due to loss to follow-up (>6mo), leaving a final sample of 249 patients (93.6%). Thirty-six cases (14.5% of the sample) were classified as having gout: twenty-three (63.9%) had a previously registered diagnosis, while 13 (36.1%) had not and was established by the interview.After discharge, the mean follow-up was 19.9 months (SD ±8.6), with a mortality incidence of 21.6 deaths per 100 patient-years, 34.2% by cardiovascular causes.Gout significantly increased the risk of subsequent all-cause mortality, with a hazard ratio (HR) of 2.01 (95%CI 1.13 to 3.58). When the analysis was restricted to gout patients with registered diagnosis, the association remained significant (HR 2.89; 95%CI 1.54 to 5.41).The adjusted HR for all-cause mortality associated with gout was 1.86 (95% CI 1.01-3.40). Regarding the causes of death, both cardiovascular and non-cardiovascular were numerically increased.Secondary variables rising the mortality risk in those with gout were age (HR 1.07; 1.01 to 1.13) and coexistent renal disease (HR 4.70; 1.31 to 16.84), while gender, gout characteristics and traditional risk factors showed no impact.Conclusion:Gout was confirmed an independent predictor of subsequent all-cause mortality in patients admitted for cardiovascular events. Active screening for gout allowed identifying a larger population at high mortality risk, which may help tailor optimal management to minimize the cardiovascular impact.References:[1]Calabuig I, et al. Front Med (Lausanne). 2020 Sep 29;7:560.Disclosure of Interests:Silvia Ruiz-Simón: None declared, Irene Calabuig: None declared, Miguel Gomez-Garberi: None declared, Mariano Andrés Speakers bureau: Grunenthal, Menarini, Consultant of: Grunenthal, Grant/research support from: Grunenthal


2020 ◽  
pp. 95-96
Author(s):  
A. K. Krekoten ◽  
A. A. Krekoten ◽  
V. N. Mutyl

A case of combined duodenal trauma in the 11-year-old patient is described. Complications of pre-operative and intraoperative diagnosis as well as complicated postoperative period are emphasized to be a cause of high mortality risk in this pathology. The disconnection of proximal and distal parts of duodenum was performed; anastomoses were placed between the common bile and pancreatic ducts and small intestine, and gastroenteroanastomosis was performed on a short loop. Follow-up traced for 10 months: recovery.


2015 ◽  
Vol 70 (1) ◽  
pp. 91-96 ◽  
Author(s):  
U Alehagen ◽  
P Johansson ◽  
M Björnstedt ◽  
A Rosén ◽  
C Post ◽  
...  

2018 ◽  
Vol 94 (1112) ◽  
pp. 335.2-347 ◽  
Author(s):  
Claire Kelly ◽  
Marinos Pericleous

Wilson disease is a rare but important disorder of copper metabolism, with a failure to excrete copper appropriately into bile. It is a multisystem condition with presentations across all branches of medicine. Diagnosis can be difficult and requires a high index of suspicion. It should be considered in unexplained liver disease particularly where neuropsychiatric features are also present. Treatments are available for all stages of disease. A particularly important presentation not to overlook is acute liver failure which carries a high mortality risk and may require urgent liver transplantation. Here, we provide an overview of this complex condition.


Author(s):  
Angela D. Friederici ◽  
Noam Chomsky

An adequate description of the neural basis of language processing must consider the entire network both with respect to its structural white matter connections and the functional connectivities between the different brain regions as the information has to be sent between different language-related regions distributed across the temporal and frontal cortex. This chapter discusses the white matter fiber bundles that connect the language-relevant regions. The chapter is broken into three sections. In the first, we look at the white matter fiber tracts connecting the language-relevant regions in the frontal and temporal cortices; in the second, the ventral and dorsal pathways in the right hemisphere that connect temporal and frontal regions; and finally in the third, the two syntax-relevant and (at least) one semantic-relevant neuroanatomically-defined networks that sentence processing is based on. From this discussion, it becomes clear that online language processing requires information transfer via the long-range white matter fiber pathways that connect the language-relevant brain regions within each hemisphere and between hemispheres.


2020 ◽  
Vol 26 (7) ◽  
pp. 904-910 ◽  
Author(s):  
S.A. Maskarinec ◽  
L.P. Park ◽  
F. Ruffin ◽  
N.A. Turner ◽  
N. Patel ◽  
...  

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