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[Spontaneous bacterial peritonitis due to Listeria monocytogenes]
1Sección de Aparato Digestivo, Hospital Marina Baixa, Villajoyosa, Alicante.
Abstract:
We present a case of spontaneous bacterial peritonitis (SBP) caused by Listeria monocytogenes in a patient previously diagnosed as alcoholic liver cirrhosis. The clinical presentation, biochemical data and outcome of the patient are compared with those of cases of SBP caused by Listeria monocytogenes in patients with cirrhosis published in the Spanish and English literature. Twelve out of 20 cases described in the literature were published by Spanish authors. This greater proportion could be related to dietary habits (greater consumption of fruits and vegetables), climatic or demographic factors. We underline the importance of pursuing a microbiological diagnosis since Listeria monocytogenes is intrinsically resistant to cefotaxime, the antimicrobial often selected to empirically treat SBP episodes.
Insights
This study reports a case of spontaneous bacterial peritonitis (SBP) caused by Listeria monocytogenes in a patient with alcoholic liver cirrhosis. Early microbiological diagnosis is crucial as Listeria monocytogenes exhibits resistance to common SBP treatments.
Area of Science:
- Infectious Diseases
- Hepatology
- Microbiology
Background:
- Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with advanced liver disease, particularly alcoholic liver cirrhosis.
- Listeria monocytogenes is an uncommon but significant pathogen causing SBP, necessitating specific diagnostic and therapeutic considerations.
Observation:
- A case of SBP caused by Listeria monocytogenes in a patient with alcoholic liver cirrhosis is presented.
- Clinical, biochemical, and outcome data were compared with 20 previously reported cases from the literature, with a notable proportion originating from Spanish authors.
- Potential contributing factors for the higher incidence in Spanish literature include dietary habits, climate, and demographic elements.
Findings:
- Listeria monocytogenes presents a unique challenge in SBP management due to its intrinsic resistance to cefotaxime, a frequently used empirical antibiotic.
- The study highlights the critical need for accurate microbiological identification to guide appropriate antimicrobial therapy.
Implications:
- Accurate and timely microbiological diagnosis is paramount for effective treatment of SBP caused by Listeria monocytogenes.
- Clinicians should consider Listeria monocytogenes in the differential diagnosis of SBP, especially in patients with liver cirrhosis, and select antibiotics accordingly, avoiding agents like cefotaxime when Listeria is suspected.