Invasive listeriosis with brain infection remains a 
diagnostic challenge with an early treatment need to reduce 
morbidity and mortality. Not only is a foodborne pathogen 
with a rising incidence but also responsible for variable 
clinical manifestations with an initial extensive differential 
diagnosis to be considered. Imaging studies such as CT scan 
and MRI are helpful, but the former is frequently normal and 
the findings of the latter are only useful when it correlates 
with a suggestive medical history, physical exam and positive 
blood or cerebrospinal fluid cultures. We report a case of 
invasive listeriosis with concomitant lung and brain infection, 
whose uncommon presentation delayed prompt diagnosis of 
the latter. Our aim is to raise awareness for these atypical 
presentations since it is so difficult to identify Listeria 
infection and patient's outcome depends on early antibiotic 
treatment start.