Autopsy revealed brain microabscess lesions consistent with <i>Listeria</i>.<h4>Conclusion</h4>Clinicians should employ prophylactic antimicrobial treatment for <i>Listeria</i> when caring for those patients presenting with cerebral edema who are immune suppressed with TNF inhibition no matter the initial exam findings, serum testing, and/or radiologic interpretation. The gene discussed is TNF; the disease is brain edema.