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Colonoscopy-associated listeriosis: report of a case
1Department of Medicine, University of Alberta, Edmonton, Canada.
Abstract:
We report a case of meningitis due to Listeria monocytogenes that occurred following colonoscopy. The patient had cirrhosis, a portosystemic shunt, and diarrhea for which she was being evaluated. Only one previous report has linked colonoscopy to listeriosis. We review the pathogenesis of listeriosis and, in particular, the evidence that prior fecal colonization is followed by bacteremia in a susceptible host. The findings in this case are consistent with this pathogenetic sequence.
Insights
A rare case of meningitis caused by Listeria monocytogenes occurred after a colonoscopy. This highlights a potential risk in susceptible patients, particularly those with liver conditions and gastrointestinal issues.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Neurology
Background:
- Listeriosis is a serious infection caused by Listeria monocytogenes.
- Colonoscopy is a common diagnostic procedure for gastrointestinal conditions.
- Patients with cirrhosis and portosystemic shunts may have increased susceptibility to infections.
Observation:
- A patient with cirrhosis, a portosystemic shunt, and diarrhea developed meningitis after a colonoscopy.
- This is only the second reported case linking colonoscopy to listeriosis.
- The patient's symptoms suggest a potential pathogenetic sequence from fecal colonization to bacteremia.
Findings:
- The case supports the hypothesis that fecal Listeria colonization can lead to bacteremia in susceptible hosts.
- The patient's underlying conditions (cirrhosis, shunt, diarrhea) likely contributed to her susceptibility.
- Meningitis following colonoscopy, though rare, is a serious potential complication.
Implications:
- Healthcare providers should be aware of the potential risk of listeriosis after colonoscopy in vulnerable patients.
- Further research may be needed to elucidate the precise mechanisms and risk factors involved.
- Prompt diagnosis and treatment are crucial for managing Listeria monocytogenes meningitis.