Related Experiment Videos
Pleural fluid infection caused by Listeria monocytogenes: case report and review
1Division of Infectious Diseases, Toronto General Hospital, Ontario, Canada.
Abstract:
Nine cases of pleural fluid infection caused by Listeria monocytogenes (one case described here and eight cases previously reported in the literature) were reviewed. Eight patients (88.9%) had an underlying malignancy (three had Hodgkin's disease, three had non-Hodgkin's lymphoma, and two had leukemia), and six (66.7%) were receiving immunosuppressive therapy at the time of presentation. Seven patients (77.8%) presented with fever and five (55.6%) with respiratory tract symptoms. Those with symptoms of greater than 3 weeks' duration had a relatively poor prognosis. Bacteremia was documented in five patients (55.6%). Examination of pleural fluid typically revealed normal levels of glucose, slightly elevated concentrations of protein, and a negative gram stain. Four patients died, for an overall mortality of 44.4%. Mortality appeared to be lower for patients who received a combination of penicillin or ampicillin plus an aminoglycoside and for those who underwent drainage of pleural fluid than for those not given such treatment. Rapid diagnosis, prompt institution of appropriate antimicrobial therapy, and drainage of the pleural fluid are likely to improve the chances for survival in listerial infection of pleural fluid.
Insights
Listeria monocytogenes pleural fluid infections are rare, often affecting immunocompromised patients with malignancy. Early diagnosis and treatment, including antibiotics and pleural fluid drainage, improve survival rates.
Area of Science:
- Infectious Diseases
- Pulmonology
- Oncology
Background:
- Pleural fluid infection caused by Listeria monocytogenes is uncommon.
- Patients with underlying malignancies and immunosuppression are at higher risk.
Observation:
- A review of nine cases of Listeria monocytogenes pleural fluid infection revealed a strong association with underlying malignancies (88.9%) and immunosuppressive therapy (66.7%).
- Common symptoms included fever (77.8%) and respiratory issues (55.6%).
- Pleural fluid analysis typically showed normal glucose, elevated protein, and negative Gram stain.
Findings:
- Bacteremia was present in 55.6% of patients.
- Mortality was 44.4%, with longer symptom duration correlating with poorer prognosis.
- Treatment with penicillin/ampicillin plus aminoglycosides and pleural fluid drainage showed improved outcomes.
Implications:
- Prompt diagnosis and treatment are crucial for improving survival in Listeria monocytogenes pleural fluid infections.
- Combination antibiotic therapy and pleural fluid drainage are recommended treatment strategies.
- Further research into optimal management of this rare infection is warranted.