Adult listeriosis—a review of 18 cases

Abstract

Summary Eighteen cases of adult listeriosis (nine with meningitis, one brain abscess and eight bacteraemia) were diagnosed in the Chaim Sheba Medical Center in the years 1964–1982. The infection seemed to be opportunistic in all. Eleven patients had malignant disease, two had cirrhosis of the liver, one had ulcerative colitis, one had bronchial asthma with chronic obstructive pulmonary disease, one had pemphigus, one had diabetes mellitus and one had a renal transplantation. Twelve patients (66%) received radiation therapy and/or cytotoxic and steroid medication. Diabetes mellitus as an additional underlying disease was strikingly frequent and was found in eight out of 18 patients (44%), in one as the only underlying disease. In the meningitis group cerebrospinal fluid (CSF) cultures were positive in five patients, and negative in four who had, however, positive blood cultures. The cells in the CSF were predominantly lymphocytes in five and polymorphs in four. It may be concluded that diabetes mellitus is an important underlying disease in listeriosis. The results also reinforce the fact that lymphocytosis in the CSF does not exclude bacterial meningitis.

Post-Colonoscopic Listeria Septicemia in Ulcerative Colitis during Immunosuppressive Therapy

“…We report a case of septicemia after colonoscopy caused by L. monocytogenes in a patient with ulcerative colitis who was receiving corticosteroids and azathioprine. We also review the pertinent previously reported cases (2,7,8). …”

“…These reported cases and the present cases are reviewed in Table 2 (2,7,8). As no patient suffered from meningitis, one possible explanation of the low frequency of Listeria meningitis in ulcerative colitis is that Listeria organisms are not transferred to the central nervous system by phagocytosis and are killed extracellularly by adequate antibiotic therapy (19).…”

Listeria monocytogenes infection in prosthetic joints

“…Both patients were elderly and one had an underlying malignancy. Coincidental bowel pathology is a common factor in many cases [21]. However, unlike the majority of L. monocytogenes infections blood cultures are usually negative in cases of prosthetic infections [17].…”

Listeria monocytogenes endocarditis

“…Listeriosis is an uncommon infection in humans but is probably best known as a cause of neonatal meningitis. It is also well recognized as an opportunistic infection in the elderly and in immuno-compromised patients (Samra et al, 1984). Within the last 5 y there have been a total of 353 isolates reported in the cerebrospinal fluid and/or blood, 103 in patients over the age of 65 y.…”