[A case of Listeria monocytogenes sepsis in an elderly who survived]

Antibiotic treatment for bacterial meningitis caused by Listeria monocytogenes in a patient with multiple myeloma

Multiple myeloma is a hematolymphoid malignancy, and patients with this disorder are frequently complicated by infection. An 80-year-old woman with multiple myeloma was complicated by bacterial meningitis, and was admitted to our hospital in August 2007. She initially received ceftriaxone, but culture of cerebrospinal fluid detected Listeria monocytogenes. Ampicillin was administered, but headache and pyrexia persisted for 2 weeks, and on cerebrospinal fluid examination, the proliferation of polymorphonuclear leukocytes had not resolved. After medication with meropenem was started, the clinical symptoms completely disappeared, and the abnormalities on cerebrospinal fluid examination resolved. The patient ultimately received meropenem for 27 days, resulting in a cure. In conclusion, meropenem is useful to treat bacterial meningitis caused by L. monocytogenes. This agent is indicated when ampicillin shows inadequate effect or if the patient has an allergy to ampicillin.

Clinical features of liver involvement in adult patients with listeriosis. Review of the literature

Clinical features of liver involvement due to Listeria monocytogenes infection in adults are rarely reported in literature. This is surprising, regarding the current opinion that the portal system is extensively involved in the first stages of pathogenesis in invasive L. monocytogenes disease. A literature search in the PubMed and Embase database revealed 34 cases with clinical features of hepatic involvement due to listeriosis. We systematically analyzed all case reports with respect to clinical manifestations, treatment and outcome. In addition, we added clinical information on a patient diagnosed with a solitary liver abscess due to L. monocytogenes, who was seen at our institution. This review describes the different presentations of liver-involvement reported in listeriosis; solitary liver abscess, multiple liver abscesses and diffuse or granulomatous hepatitis. Distinction between these different forms of liver involvement is clinically relevant as they have a different outcome. We delve into the different pathogenic events leading to different forms of liver involvement. In addition, diagnostic modalities and possible treatments are reviewed.