Unusual Listeria monocytogenes hematogenous infection in total knee replacement treated with one-stage revision surgery

Spontaneous spondylodiscitis and epidural abscess due to Listeria monocytogenes in a middle-aged patient with gentamicin related side effects: A case report and a review of literature

Introduction

Primary spondylodiscitis due to Listeria monocytogenes (LM) is a rare condition.

Research question

We present a case of spontaneous LM spondylodiscitis with an epidural abscess in a middle-aged man, who reported no gastrointestinal infection.

Material and methods

We identified 5 spinal infection cases due to LM in the literature, with 3 diagnosed as primary spondylodiscitis.

Results

The patient was treated with surgical decompression, debridement, and antibiotic therapy. Blood cultures remained negative throughout the case and microbiological cultures were obtained during surgery. The patient developed side-effects of prolonged gentamicin therapy but made a recovery from his spinal complaints at 6-months follow-up. Listeriosis is a relatively rare food-borne disease with a wide spectrum of presentation. Surgeons should consider more aggressive therapy for spinal infections and recognize the uncommon manifestations. We identified 3 primary and 2 secondary LM spondylodiscitis cases in the literature. Antibacterial treatment of LM spondylodiscitis varied in agents and duration, but no side-effects were previously reported. Gentamicin treatment requires care and attention to complications.

Discussion and conclusion

Listeria monocytogenes is a rare cause of primary spondylodiscitis. Further studies are needed to establish a safe treatment protocol for treatment with gentamicin and LM spondylodiscitis.

Treatment of Prosthetic Joint Infection due to Listeria Monocytogenes. A Comprehensive Literature Review and a Case of Total Hip Arthroplasty Infection

As reported in contemporary literature, prosthetic joint infection (PJI) caused by Listeria monocytogenes (LM) is a rare infection affecting mainly immunocompromised patients. It is considered a late complication occurring months or years after the arthroplasty that is treated with, or without, implant retention, in one-stage or two-stage surgical procedures, and long-term administration of antibiotics. We reviewed the published studies in the English language and present a case of a patient who underwent total hip arthroplasty (THA) and had been affected by this infection. Our patient was successfully treated with 3 months of antibiotics (ampicillin and TMP/SMX) and a two-stage surgical procedure. The success rates of conservative treatment and one-stage or two-stage procedures are dependent on appropriate patient selection and chronicity of the infection. Ιmmmunocompromised patients are susceptible to PJI caused by LM and should be advised that consumption of unpasteurized dairy products increases the risk of this atypical infection.