We present diffusion-weighted imaging findings of a case of rhombencephalitis due to Listeria monocytogenes. It is a rare, life-threatening disorder. The diagnosis is difficult by clinical findings only. In this report, we aim to draw attention to the role of conventional and diffusion-weighted magnetic resonance imaging findings. To our knowledge, this is the first case report in the literature with apparent diffusion coefficient values of diseased brain parenchyma.
[Show abstract][Hide abstract] ABSTRACT: Listeria monocytogenes is a facultative intracellular bacterium that has predilection for causing central nervous systemic infections in humans and domesticated animals. This pathogen can be found worldwide in the food supply and most L. monocytogenes infections are acquired through ingestion of contaminated food. The main clinical syndromes caused by L. monocytogenes include febrile gastroenteritis, perinatal infection, and systemic infections marked by central nervous system infections with or without bacteremia. Experimental infection of mice has been used for over 50 years as a model system to study the pathogenesis of this organism including the mechanisms by which it invades the brain. Data from this model indicate that a specific subset of monocytes, distinguished in part by high expression of the Ly-6C antigen, become parasitized in the bone marrow and have a key role in transporting intracellular bacteria across the blood-brain barriers and into the central nervous system. This Minireview will summarize recent epidemiologic and clinical information regarding L. monocytogenes as a human pathogen and will discuss current in vitro and in vivo data relevant to the role of parasitized monocytes and the pathogenetic mechanisms that underlie its formidable ability to invade the central nervous system.
[Show abstract][Hide abstract] ABSTRACT: Diffusion-weighted magnetic resonance imaging (DWI) is a technique based on diffusion of water molecules in tissues, with
clinical applications to a wide array of pathological conditions. Currently, DWI is the most reliable method for detection
of early and small ischemic infarcts in the brain and the gold standard for determination of the infarct core. DWI is also
an important sequence for characterization of various neoplastic conditions such as epidermoid tumors, lymphomas, and high-grade
astrocytomas and enables distinction of pyogenic abscesses from ring-enhancing intracranial neoplasms. Additional applications
of DWI include differentiation of vasogenic edema syndromes from acute ischemia, identification of acute demyelinating lesions,
and characterization of encephalitides, toxic and metabolic lesions, and diffuse axonal injury. This chapter provides an overview
of current clinical applications of DWI as well as potential future applications of DWI currently under investigation, including
its use for prediction of complications and outcomes of ischemic strokes and distinction of tumor progression from treatment-related
[Show abstract][Hide abstract] ABSTRACT: Les infections cérébrales sont relativement rares mais potentiellement graves avec un mauvais pronostic. La pierre angulaire du diagnostic est l’analyse du liquide cérébrospinal. L’imagerie n’est pas systématique mais ses indications sont larges, en particulier devant la suspicion d’une atteinte focale, en fonction du terrain (enfant, immunodépression, origine géographique…). Elle repose sur l’IRM qui permet le diagnostic étiologique et le bilan d’extension. De plus, dans un certain nombre de cas, l’infection n’est pas connue et il revient à l’IRM grâce à une technique exhaustive, de diagnostiquer une origine infectieuse devant un syndrome de masse. Cette maîtrise technique, associée à la connaissance des grandes infections cérébrales, de leur mode de contamination et de leur aspect particulier en IRM, doit permettre au radiologue de remplir son rôle diagnostique.
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