infectious rhombencephalitis

 Q: What is the most common cause of infectious rhombencephalitis?

Answer: Listeria meningitis 

Rhombencephalitis is also called brainstem encephalitis, and is clinically manifested as 

• ataxia
• cranial nerve palsies, and/or 
• nystagmus

Surprisingly, it occurs in healthy young adults. Diagnosis can be confirmed by aligning history, physical exam, blood cultures, lumbar puncture, and MRI. One of the cardinal features of history is the report of biphasic illness i.e., signs of brainstem dysfunction as described above first preceded by a prodromal flu-like syndrome. 

Ampicillin is the treatment of choice.

#infectious-diseaes

References:

1. Mylonakis E, Hohmann EL, Calderwood SB. Central nervous system infection with Listeria monocytogenes. 33 years' experience at a general hospital and review of 776 episodes from the literature. Medicine (Baltimore) 1998; 77:313. 

2. Charlier C, Perrodeau É, Leclercq A, et al. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study. Lancet Infect Dis 2017; 17:510. 

3. Jubelt B, Mihai C, Li TM, Veerapaneni P. Rhombencephalitis / brainstem encephalitis. Curr Neurol Neurosci Rep. 2011 Dec;11(6):543-52. doi: 10.1007/s11910-011-0228-5. PMID: 21956758.