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Ventriculoperitoneal shunt infection with Listeria innocua
Arzu Karli1, Gulnar Sensoy, Nevzat Unal
1Department of Pediatric Infectious Diseases, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Abstract:
Listeria species may cause life-threatening events including meningitis and invasive infection in newborns, pregnant women, older and immunodeficient people. The most common Listeria species that causes infection is L. monocytogenes. It is known that Listeria innocua has no pathogenicity. A 9-month-old baby had ventriculoperitoneal shunt and was treated with adrenocorticotropic hormone because of infantile spasms. He was brought to hospital with fever and vomiting. Upon physical examination, the patient seemed uncomfortable and had a temperature of 38.6°C. Laboratory results were as follows: hemoglobin, 6.7 g/dL; leukocyte count, 5420/mm(3) ; platelet count, 169,000/mm(3) ; and C-reactive protein, 100 mg/L (normal <5 mg/L). On analysis of cerebrospinal fluid (CSF), leukocyte count was 480/mm(3) , protein was 46 mg/dL and CSF glucose was 35 mg/dL. L. innocua was isolated in CSF culture. We describe this unusual case of ventriculoperitoneal shunt infection with L. innocua.
Insights
This case report details a rare Listeria innocua infection in a 9-month-old infant with a ventriculoperitoneal shunt. The findings challenge the assumption that Listeria innocua is non-pathogenic, highlighting a potential cause of meningitis.
Area of Science:
- Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Listeria species, particularly Listeria monocytogenes, are known pathogens causing severe infections like meningitis.
- Listeria innocua is generally considered non-pathogenic, with no documented cases of causing invasive infections.
Observation:
- A 9-month-old infant with a ventriculoperitoneal shunt and infantile spasms presented with fever and vomiting.
- Cerebrospinal fluid analysis revealed elevated leukocytes and protein, with low glucose.
- Listeria innocua was isolated from the cerebrospinal fluid culture.
Findings:
- This is the first reported case of ventriculoperitoneal shunt infection caused by Listeria innocua.
- The isolation of L. innocua from cerebrospinal fluid suggests a potential pathogenic role in this specific clinical context.
Implications:
- This case expands the spectrum of Listeria pathogenicity, indicating L. innocua can cause serious infections, especially in immunocompromised individuals or those with medical devices.
- Clinicians should consider L. innocua in the differential diagnosis of meningitis or shunt infections, even when L. monocytogenes is not suspected.
- Further research is needed to understand the pathogenic mechanisms of L. innocua and its clinical significance.
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