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Listeria monocytogenes Infection of the Brain
05:02

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Spontaneous Bacterial Peritonitis Caused by Infection with Listeria monocytogenes

Michael Vincent F Tablang1

  • 1Department of Internal Medicine, University of Connecticut Health Center, Farmington, Conn., USA.

Case Reports in Gastroenterology
|April 15, 2011
PubMed

Insights

Spontaneous bacterial peritonitis (SBP) is a severe liver disease complication. This case highlights Listeria monocytogenes as a rare SBP cause, requiring specific antibiotic treatment beyond standard therapy.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Microbiology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with advanced liver disease and ascites.
  • Coliform bacteria are the most common pathogens, typically treated with third-generation cephalosporins.
  • Autoimmune hepatitis leading to liver cirrhosis is a significant risk factor for ascites.

Observation:

  • An uncommon case of SBP caused by Listeria monocytogenes in a female patient with autoimmune hepatitis-induced liver cirrhosis.
  • The patient exhibited an inadequate response to ceftriaxone, a standard empiric antibiotic for SBP.
  • Clinical deterioration included hepatic encephalopathy, seizures, and multi-organ failure.

Findings:

  • Listeria monocytogenes is a rare but critical cause of SBP in end-stage liver disease.
  • Failure to improve with conventional antibiotics within 48-72 hours suggests an alternative pathogen.
  • Prompt diagnosis and initiation of ampicillin/sulbactam are crucial for Listerial peritonitis.

Implications:

  • Clinicians must maintain a high index of suspicion for atypical SBP pathogens like Listeria.
  • Early recognition and targeted antibiotic therapy are vital for improving outcomes in complicated SBP.
  • This case underscores the need for tailored treatment strategies in liver cirrhosis patients with refractory SBP.
Keywords:
AscitesCirrhosisListeriaPeritonitisSepsis

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