Stroke-like manifestations in a patient with Listeria monocytogenes abscess and Horton's arteritis

Brain abscesses due to Listeria monocytogenes are rare and are a clinical challenge. We report the case of a 72-year old female patient under immunosuppressive treatment for Horton's arteritis who was admitted with an initial diagnosis of ischemic stroke. Further workup revealed listerial abscesses as the cause of her neurological symptoms. She was treated with ampicillin plus gentamicin with an excellent outcome. In spite of the rarity of this entity, immunosuppresive drugs are the most important predisposing factors. These drugs are widely used and consequently there is an increased number of subjects at risk of listerial brain abscesses.