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Pleural-pulmonary aspects of Listeria monocytogenes infection
Abstract:
The most common forms of Listeria monocytogenes infection in adults are meningitis-encephalitis and sepsis. Infection of the pulmonary parenchyma and pleura have rarely been reported. A case of listeria meningitis presenting with pleural space infection in an immunosuppressed patient is presented and a review of 5 additional patients with listeria infection of the respiratory tract is included. All 6 patients described in this report had L. monocytogenes infections presenting with respiratory tract symptomatology, although 4 patients subsequently had positive blood or cerebrospinal fluid cultures. It is emphasized that a culture report of 'diphtheroids' from a thoracentesis specimen should not be automatically dismissed as contamination, particularly in an immune compromised patient.
Insights
Listeria monocytogenes can cause rare lung infections, even in immunocompromised adults. Diphtheroid findings in pleural fluid require careful review to avoid missing Listeria.
Area of Science:
- Infectious Diseases
- Microbiology
- Pulmonology
Background:
- Listeria monocytogenes commonly causes meningitis and sepsis in adults.
- Pulmonary and pleural infections due to Listeria are infrequently reported.
- Immunocompromised individuals are at higher risk for invasive Listeria infections.
Observation:
- This report details a case of Listeria meningitis with concurrent pleural space infection in an immunosuppressed patient.
- A review of five additional patients with Listeria respiratory tract infections is presented.
- All six patients exhibited respiratory symptoms, with four later showing positive blood or cerebrospinal fluid cultures.
Findings:
- Listeria monocytogenes can manifest with respiratory tract symptomatology.
- Pleural effusions may be associated with Listeria infection.
- Diphtheroid identification in thoracentesis fluid warrants further investigation in at-risk patients.
Implications:
- Clinicians should consider Listeria monocytogenes in the differential diagnosis of respiratory and pleural infections, especially in immunocompromised patients.
- The significance of 'diphtheroids' in pleural fluid cultures should be re-evaluated, particularly in immunocompromised hosts.
- Early recognition and treatment of invasive Listeria infections are crucial for patient outcomes.