Liver Abscess Due to Listeria monocytogenes: Case Report and Review

Braun, Todd I.; Travis, David; Dee, Robert R.; Nieman, Roger E.

doi:10.1093/clinids/17.2.267

Cited by 32 publications

(18 citation statements)

References 13 publications

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“…Unlike our subjects, these patients were severely ill and bacteremic, and most had transaminases in the thousands, presumably related to diffuse bacteremic seeding of the liver. There are also reports of hepatic abscesses (single or multiple) caused by L. monocytogenes (6), in one case in an asymptomatic individual (37). In these descriptions, liver function tests reflect the more cholestatic laboratory findings typically noted for bacterial hepatic abscesses, e.g., modest elevations in alkaline phosphatase and fairly normal transaminases.…”

Section: Discussionmentioning

confidence: 99%

Safety and Shedding of an Attenuated Strain ofListeria monocytogeneswith a Deletion ofactA/plcBin Adult Volunteers: a Dose Escalation Study of Oral Inoculation

et al. 2002

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Listeria monocytogenes is an intracellular bacterial pathogen which causes bacteremia and has a tropism for the central nervous system and a propensity to cause maternofetal infection. L. monocytogenes has been shown to be an effective prophylactic and a therapeutic vaccine vector for viral and tumor antigens in animal models. L. monocytogenes mutants lacking the ActA protein, which is essential for intracellular movement, are attenuated but retain immunogenicity in mice. Given the pathogenic potential of L. monocytogenes, we created an attenuated mutant strain bearing double deletions in the actA and plcB virulence genes for an initial clinical safety study of a prototype L. monocytogenes vector in adults. Twenty healthy volunteers received single escalating oral doses (10 6 to 10 9 CFU, 4 volunteers per dose cohort) of this attenuated L. monocytogenes, designated LH1169. Volunteers were monitored in the hospital for 14 days with frequent clinical checks and daily blood and stool cultures, and they were monitored for six additional weeks as outpatients. There were no positive blood cultures and no fevers attributable to the investigational inoculation. Most volunteers shed vaccine bacteria for 4 days or less, without diarrhea. One volunteer had a late positive stool culture during outpatient follow-up. Three volunteers had abnormal liver function test results temporally associated with inoculation; one could be reasonably attributed to another cause. In the highest-dose cohort, humoral, mucosal, and cellular immune responses to the investigational organism were detected in individual volunteers. Attenuated L. monocytogenes can be studied in adult volunteers without serious long-term health sequelae.Listeria monocytogenes is a gram-positive bacterium which has long been studied in mice to elucidate mechanisms of cellular immune responses to intracellular pathogens (29, 35). Schafer and colleagues initially proposed that escape of L. monocytogenes from the phagocytic vacuole into the eukaryotic cytoplasm might make these organisms efficient vectors for delivery of antigens to the major histocompatibility complex class I-restricted antigen processing pathways (48). L. monocytogenes vectors have been used to deliver lymphocytic choriomeningitis virus (LCMV) nucleoprotein antigens to mice, with subsequent protection against fatal challenge with LCMV (21, 52, 53). Recombinant L. monocytogenes expressing cottontail rabbit papillomavirus E1 antigen has been successfully used as a therapeutic immunogen in animals bearing papillomavirus-induced cutaneous tumors (28). L. monocytogenes is being pursued as a vector for antigens derived from human papillomaviruses (23) and human immunodeficiency virus type 1 (HIV-1) (40,41). A murine study showed that oral inoculation of L. monocytogenes expressing HIV-1-gag induced mucosal and systemic immunity to this viral antigen (45). After careful review of available data on oral inoculation of wild-type L. monocytogenes in primates (17) and farm animals, (34,42,43) clinical data avail...

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Section: Discussionmentioning

confidence: 99%

Safety and Shedding of an Attenuated Strain ofListeria monocytogeneswith a Deletion ofactA/plcBin Adult Volunteers: a Dose Escalation Study of Oral Inoculation

et al. 2002

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“…In Braun's review of liver abscesses due to L. monocytogenes [3], all the patients with multiple liver abscesses expired, while those with solitary ones survived.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous supratentorial and brainstem abscesses due to Listeria monocytogenes

Soares-Fernandes

Beleza

Cerqueira

et al. 2008

Journal of Neuroradiology

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Multiple supratentorial abscesses caused by Listeria monocytogenes are rare. We report the simultaneous occurrence of multiple supratentorial and brainstem abscesses due to Listeria, in a patient under corticotherapy for an exacerbation of ulcerative colitis. MR imaging features before and after successful conservative treatments are depicted. In immunocompromised patients with supratentorial listerial abscesses, the coexistence of brainstem abscedation is exceptional. Despite high mortality associated with listerial abscesses, this case illustrates the possibility of a good clinical outcome, if the appropriate antibiotic regimen is instituted and the immunosuppressant agent is discontinued. © 2007 Elsevier Masson SAS. All rights reserved. MOTS CLÉS

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“…There have been rare reports of focal infections from which L. monocytogenes isolates have been recovered; cases include direct inoculation of the organism, resulting in conjunctivitis [8], skin infection [84], and lymphadenitis [8]. Listerial bacteremia can led to the development of hepatitis and hepatic abscess [85,86], cholecystitis [87], peritonitis [88,89], splenic abscess [8], pleuropulmonary infection [90][91][92], joint infection [93], osteomyelitis [94], pericarditis [95], myocarditis [96], arteritis [97], and endophthalmitis [8]. There is nothing clinically unique about these localized infections: many-but not all have occurred in patients known to be at risk for listeriosis.…”

Section: Clinical Syndromesmentioning

confidence: 99%