PMC6348973_01
MRI findings and OB found in the CSF on admission.. Notes: MRI of the brain revealed nodular regions of abnormal signal in the medulla oblongata and cervical cord, characterized by hyper-intensity on (A) T2-weighted and (B) flair sequences (arrow). (C and D) Nodular enhancing lesions were detected in the medulla oblongata and cervical cord (arrow). (E) OB found in the CSF (arrow).. Abbreviations: CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; OB, oligoclonal band.
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However, an oligoclonal band (OB) was found in the CSF (Figure 1E). MRI of the brain revealed nodular regions of abnormal signal in the medulla oblongata and cervical cord, characterized by hyper-intensity on T2-weighted and fluid attenuated inversion recovery (flair) sequences (Figure 1A and B). After gadolinium injection, nodular enhancing lesions were also detected in the medulla oblongata and cervical cord (Figure 1C and D).
MRI findings and bacterial cultures when the patient's condition worsened.. Notes: Repeat MRI was performed and the lesions were found not only in the brainstem but also in the cerebellum with a hyper-intensity on (A) T2-weighted and (B) flair sequences (arrow). (C) Bacterial cultures were taken and Lm was identified. (D and E) The lesions were found patched or ring gadolinium-enhanced with abscess-like appearances (arrow). (F) Gram staining of the bacteria.. Abbreviations: Lm, Listeria monocytogenes; MRI, magnetic resonance imaging.
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T2-weighted and flair sequences (Figure 2A and B). The lesions were also found to be patched or ring gadolinium-enhanced with abscess-like appearances (Figure 2D and E). Finally, the blood or CSF sample was cultured on the blood agar plates (Figure 2C), isolates were subjected to Gram staining (Figure 2F), then species identification and drug susceptibility were analyzed by VITEK2 compact (bioMerieux, Craponne, France), and Lm was identified in both blood and CSF.