<i>Listeria monocytogenes</i> endocarditis

Sheinman, B. D.; Evans, Thomas J.; Sage, Roger

doi:10.1136/pgmj.61.711.51

Cited by 18 publications

(4 citation statements)

References 4 publications

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“…Of these, infective endocarditis is probably the commonest. Several cases of infective endocarditis have been reviewed in the literature (4,75,79,94). The commonest therapy used was ampicillin or penicillin, with or without an aminoglycoside, and cephalosporin treatment was uniformly ineffective.…”

Section: Antimicrobial Therapy Of Rarer Infective Manifestationsmentioning

confidence: 99%

Antimicrobial chemotherapy of human infection due toListeria monocytogenes

Jones¹,

MacGowan²

1995

Eur. J. Clin. Microbiol. Infect. Dis.

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Listeriosis is an uncommon infection, but when it occurs it carries a high mortality rate. Early diagnosis is essential and thereafter appropriate antimicrobial chemotherapy. Ampicillin or penicillin plus gentamicin remains the treatment of choice for most manifestations of listeriosis, and adequate doses must be given, i.e. greater than 6g/day of ampicillin or penicillin. Co-trimoxazole appears to be an excellent alternative agent with good penetration into the cerebrospinal fluid. Vancomycin is an appropriate agent for the treatment of primary bacteraemia but does not cross the blood-brain barrier sufficiently well to be useful in meningitis, while erythromycin may be used to treat listeriosis in cases of pregnancy. Treatment of bacteraemia requires one to two weeks' therapy, while meningitis cases may need to be treated for longer; for example, it has been found that most patients with acute meningitis in the UK were treated for 20 days. Infective endocarditis needs treatment for six to eight weeks. Doses should be varied with patients' altered organ function and antimicrobial serum monitoring performed when appropriate.

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Section: Antimicrobial Therapy Of Rarer Infective Manifestationsmentioning

confidence: 99%

Antimicrobial chemotherapy of human infection due toListeria monocytogenes

Jones¹,

MacGowan²

1995

Eur. J. Clin. Microbiol. Infect. Dis.

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“…Second, TEE showed vegetation on the mitral valve. Listerial endocarditis is usually associated with predisposing factors such as underlying rheumatic valve disease, prosthetic valves, or other structural heart diseases such as hypertrophic obstructive cardiomyopathy [ 11 ]. However, our patient had none of these predisposing heart conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Listeria monocytogenes has a predilection for the CNS [10], with meningitis as the most common presentation especially in patients with altered cell-mediated immunity [10][11][12]. Brain abscess is a serious but rare manifestation of listerial infection, accounting for approximately 1-10% of cases [5,10].…”

Section: Introductionmentioning

confidence: 99%

Listeria Bacteremia Presenting With Cerebral Abscess and Endocarditis in an Elderly Patient With Chronic Immune Thrombocytopenia

Ogunleye¹,

Karimi²,

Gujadhur³

2021

Cureus

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Central nervous system involvement by Listeria monocytogenes usually presents as meningitis, meningoencephalitis or, less frequently, rhombencephalitis. Listerial brain abscesses are rare. Moreover, only 5-8% of listerial bacteremia is complicated by infective endocarditis (IE). A 70-year-old man with chronic immune thrombocytopenia (ITP) presented to our emergency department with acute onset of altered mental status and right-sided weakness. He was afebrile, with no heart murmurs or peripheral IE stigmata. Neurologic examination showed disorientation, expressive aphasia, and right-sided hemiparesis. Laboratory findings were unremarkable except for leukocytosis and hyponatremia. Brain MRI showed an irregular rim-enhancing lesion in the left frontal lobe, suspicious for a high-grade glial neoplasm. The lesion was excised, and he was started empirically on vancomycin, ceftriaxone, and metronidazole. After blood cultures grew Listeria monocytogenes, antibiotics were de-escalated to ampicillin and gentamicin. Echocardiography showed mitral valve vegetation. By Day 6, his mental status had improved. On Day 9, he was discharged to our inpatient rehabilitation center to complete six weeks on IV ampicillin and IV gentamicin. Pathology of the brain mass was subsequently reported as a listerial brain abscess. Chronic treatment with high-dose oral glucocorticoids and pre-existing ITP have been independently implicated as predisposing factors in listerial brain abscess. There is a propensity to misdiagnose listerial brain abscess as an intracranial neoplasm due to similar clinical/imaging findings. In addition, Listeria monocytogenes is an atypical cause of IE. Therefore, a high index of suspicion is necessary for early recognition and successful treatment of listerial brain abscess and listerial endocarditis in high-risk patients.

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“…The present communication highlights the grave prognosis and the need to be vigilant to identify L. monocytogenes as it maybe wrongly dismissed as culture contaminant [5] because of its diphtheroid [4,5] appearance and therefore may be underreported.…”

Section: Neonatal Listeriosis: a Case Report From Sub-himalayasmentioning

confidence: 99%