Case Report Multiple cortical brain abscesses due to Listeria monocytogenes in an immunocompetent patient Sadia Khan 1 , Anil Kumar 2 , Satyajit Kale 3 , Nitin Kurkure 4 , Gulsiv Nair 5 and Kavitha Dinesh 6 Abstract Listeria monocytogenes is an intracellular organism which is well recognised for its ability to cause meningeal infections in neonates, immunosuppressed, debilitated and elderly individuals. 1 Other less common central nervous system (CNS) infections caused by Listeria spp. include rhomboencephalitis, cerebritis and abscesses in the brain, brain stem and spinal cord. The neuroradiological appearance of Listeria brain abscesses is similar to other types and may also mimic primary or metastatic brain tumours. 2,3 We report a case of Listeria brain abscesses in a patient who was being treated for atypical parkinsonism. A good clinical outcome was achieved after appropriate antimicrobial therapy. Keywords Listeria monocytogenes, multiple brain abscesses, Listeria brain abscess Case Report A 52-year-old woman, previously diagnosed with sys- temic hypertension and an extrapyramidal syndrome, presented with a one-week history of headache and gradual diminution of vision. She had been taking levo- dopa-carbidopa 400 mg/day in divided doses for an extrapyramidal syndrome and losartan 50 mg/day for hypertension over the previous two years. There had been a poor response to treatment and she had been referred for evaluation of autoimmune causes of atyp- ical parkinsonism. Her headache started as a mild, holocranial, continuous, non-throbbing pain with no aggravating or relieving factors. This was associated with painless, progressive, diminution of vision in both eyes. At the time of admission, she could only make out fingers at a close distance. She had one sei- zural episode on the day of admission with clenching of teeth, frothing followed by tonic-clonic movements of all four limbs which lasted for 2–3 min, followed by post-ictal confusion and drowsiness. She did not give any past history of seizures, auras, limb weakness or bowel and bladder incontinence, and was not allergic to any medication. On examination, she was afebrile, had a normal pulse rate (72 beats/min) and blood pressure (140/90 mmHg). She was conscious, oriented and cooperative. She had a mildly impaired attention span with hypophonia. Her vision was markedly impaired in both eyes but with intact perception of light rays. Other cranial nerves were functioning normally. There was cog wheel rigidity in all four limbs, which were accen- tuated on the left side. Intentional tremors were seen in both upper limbs, more towards the left. Her tandem walking was impaired, with bradykinesia and postural instability, as well as oral dyskinesia. Laboratory investigations revealed an elevated white blood cell count (13,200 cells/mm 3 ) and C-reactive 1 Clinical Associate Professor, Department of Microbiology, Amrita Institute of Medical Sciences, Kochi, India 2 Clinical Professor, Department of Microbiology, Amrita Institute of Medical Sciences, Kochi, India 3 Research Scholar, Department of Pathology, Maharashtra Animal & Fishery Sciences University, Nagpur, India 4 Associate Professor, Department of Pathology, Maharashtra Animal & Fishery Sciences Univeristy, Nagpur 5 Junior Resident, Department of Microbiology, Amrita Institute of Medical Sciences, Kochi 6 Clinical Professor, Department of Microbiology, Amrita Institute of Medical Sciences, Kochi Corresponding author: Sadia Khan, Clinical Associate Professor, Department of Microbiology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Amrita University, Kochi 682041, India. Email: drsadiakhan83@gmail.com Tropical Doctor 0(0) 1–4 ! The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0049475517728670 journals.sagepub.com/home/tdo