Listeria monocytogenes prosthetic valve endocarditis

Area of Science:

• Infectious Diseases
• Cardiology
• Medical Microbiology

Background:

• Prosthetic valve endocarditis (PVE) is a serious complication following cardiac valve replacement surgery.
• Listeria monocytogenes is an uncommon pathogen implicated in PVE, often presenting as a late-onset infection.

Observation:

• This report details four cases of PVE caused by Listeria monocytogenes.
• All reported cases presented as late complications, occurring after initial valve replacement.
• The causative agent was identified as Listeria monocytogenes in all instances.

Findings:

• Bacteriologic cure was achieved in all patients treated with standard antibiotic regimens, including penicillin or penicillin plus an aminoglycoside.
• Two fatalities were recorded, both associated with Starr-Edwards aortic prostheses.
• Deaths were attributed to embolic phenomena, occurring despite successful bacteriologic sterilization of the infected valve.

Implications:

• Effective antibiotic therapy can eradicate Listeria monocytogenes from infected prosthetic valves.
• Embolic complications remain a significant risk, even after successful infection control, particularly in patients with specific types of aortic prostheses.
• This highlights the need for vigilant monitoring and potential anticoagulation strategies in patients with PVE caused by Listeria monocytogenes.