In Reply We thank Budhram and Kim for their observations on our article.1 We agree with their comment regarding the role of differential diagnosis between a relapse and an acute infection of the central nervous system. This remains a crucial point in treating patients with multiple sclerosis, especially while they are receiving treatment with disease-modifying drugs. They correctly underline how an appropriate and fast treatment could reduce the neurological complications of central nervous system infections. Therefore we believe that our case report is useful in valuing the role of a deep anamnesis and emphasizes the need to explore all possible differential diagnoses when a new neurological symptom is reported from patients.
Ruggieri S, De Giglio L. Listeria Monocytogenes–Induced Rhombencephalitis—A Paradoxical Disease of Immunocompetent Patients—Reply. JAMA Neurol. 2018;75(11):1442–1443. doi:10.1001/jamaneurol.2018.2744
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