Cerebral Ring Enhancing Lesions in Autoimmune Hepatitis Complicated by Invasive Listeriosis

Muhammad Hasnat Akhtar, Dr. Tahir Iqbal, Syed Mohammad Mehmood Abbas, Maimuna Sultana, Muhammad Moseeb Ali Hashim, Dr Sakina Batool

Abstract: listeria monocytogenes is an opportunistic gram - positive, anaerobic, facultative intracellular bacterium that imposes great variety of complications in immunocompromised patient. Its effects ranges from liver abscess, acute gastroenteritis, septic arthritis to the neurological complications like rhombencephalitis, meningitis. Brain abscesses caused by listeria monocytogenes is extremely rare, where it mimic like circling disease of animals. We report a case of invasive case of listeriosis causing multiple brain lesions in cerebral cortex, presenting with no signs of fever with sudden unilateral hemiparesis mimicking cerebral palsy. We encourage early diagnosis by CSF and blood culture, and its correlation with MRI ring enhancing lesion findings. Furthermore prompt treatment by gentamycin, vancomycin can settles down complications and saves patient life. We put emphasis on timely diagnosis and treatment to avoid any further complication in already an immunocompromised patient.

Keywords: Cerebral Ring - Enhancing lesions, Autoimmune Hepatitis, Invasive Listeriosis