#idboardreview 65 F w/ ataxic gait, R nystagmus, dysmetria. MRI T2 hyperintensity in cerebellum extension to brainstem/internal capsule bilaterally. CSF 200wbc 95%PMN, gluc65, protein160. Diagnosis? #medEd #idmedEd #idtwitter ImageImage
Patient likes to eat Brie
#Rhombencephalitis is encephalitis that affects hindbrain.
Non-infectious ddx MS, Behçet, paraneoplastic syndromes

infectious ddx L. monocytogenes, EBV, MTB, Streptococcus pneumoniae
#listeria gram-positive facultative intracellular bacterium
Reservoir & flowing bodies of water facilitate spread
Ready-to-eat foods, soft cheeses, undercooked or inadequately reheated meats, delicatessen meats are common modes of transmission
Risk factors #listeriosis extremes of age, pregnancy, immunosuppression, malignancy or diabetes
#listeriosis CSF may be non-specific but often include a raised protein, a normal or low glucose and a lymphocytosis, although a CSF neutrophilia may also be seen
Tx ampicillin + gent or amp+tmp-smx

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