Primary spontaneous listerial peritonitis

Spontaneous peritonitis by listeria - an uncommon challenge

“…Mastroianni A et al described an interesting case of spontaneous peritonitis by Listeria monocytogenes, an uncommon condition with estimated 30% of mortality and more often associated with ascites due to liver diseases or pulmonary hypertension. [1][2][3][4] . The old patient had liver cirrhosis and hepatocarcinoma, voluminous ascites with typical pattern of spontaneous bacterial peritonitis (SBP), and L. monocytogenes in cultures; he underwent empirical ceftriaxone and ciprofloxacin, but evolved to death in three days.…”

“…1 Taken in account the possibility of unsuspected, misdiagnosed, or under reported Listeria infections, comments on some additional cases may enhance the suspicion index, mainly in small children, people with livestock contact, and immunocompromised people. [2][3][4] Brazilian authors reported a 45-year-old woman underwent corticosteroid therapy for systemic lupus erythematosus and developed a milky ascites with triglycerides: 54 mg/dl, leukocytes: 2650/mm 3 (75% polymorphonuclear), the serum-ascites albumin gradient < 1.1mg/dl, and negative tests for the presence of bacteria and mycobacteria. 2 One week later, she had neurological disturbances and cerebrospinal fluid (CSF) samples revealed meningitis by L. monocytogenes, successfully managed by meropenem.…”

“…3 Tholany J et al reported a mid-60s man with liver cirrhosis who had fever, and ascites presenting neutrophils over than 7000/mm 3 and culture positive for L. monocytogenes. 4 With diagnosis of SBP, he underwent ceftriaxone, metronidazole and vancomycin, later changed for monotherapy with ampicillin, and by amoxicillin on the hospital discharge. Worthy of note, after 21 weeks of treatment has been asymptomatic over than one year.…”

“…Worthy of note, after 21 weeks of treatment has been asymptomatic over than one year. 4 The article of reference, and additional comments, can increase the awareness of health care workers about opportunistic Listeria infections, mainly in people at high risk; the early diagnosis and prompt effective treatment propitiate more favorable outcomes.…”