Is Listeria monocytogenes an important pathogen for prosthetic joints?

Area of Science:

• Infectious Diseases
• Rheumatology
• Orthopedic Surgery

Background:

• Listeria monocytogenes typically causes meningitis or bacteremia in immunocompromised individuals.
• Septic arthritis is an uncommon manifestation of Listeria monocytogenes infection.
• Patients with underlying conditions and prosthetic joints are at increased risk.

Purpose of the Study:

• To report a fatal case of septic arthritis caused by Listeria monocytogenes in a patient with rheumatoid arthritis and a hip replacement.
• To review previously reported cases of Listeria monocytogenes septic arthritis to identify risk factors and outcomes.
• To alert clinicians to the possibility of Listeria monocytogenes in specific patient populations.

Main Methods:

• Case report of a patient with Listeria monocytogenes septic arthritis.
• Systematic review of 18 previously reported cases of Listeria monocytogenes septic arthritis.
• Analysis of patient demographics, underlying conditions, treatments, and outcomes.

Main Results:

• Listeria monocytogenes septic arthritis is associated with rheumatoid arthritis, diabetes, neoplastic disease, immunosuppressive therapy, and prosthetic joints.
• The reported case resulted in death, likely due to adult respiratory distress syndrome, a rare complication.
• Appropriate antibiotic treatment (penicillin or ampicillin) generally yields favorable outcomes, but complicating factors can be fatal.

Conclusions:

• The combination of immunosuppression, specific medical disorders, and prosthetic joints should raise suspicion for Listeria monocytogenes.
• Listeria monocytogenes septic arthritis is a serious condition that can be fatal, especially in immunocompromised patients.
• Prompt diagnosis and treatment with appropriate antibiotics are crucial for favorable outcomes in Listeria monocytogenes infections.