Listeria Infected Pseudoaneurysm of the Superficial Femoral Artery.

We present a unique case of listeria-infected pseudoaneurysm of the superficial femoral artery. Listeria monocytogenes, a gram positive, intracellular bacterium, is widespread in the environment. The manifestation of infection in humans ranges from mild gastroenteritis to life-threatening listeriosis. The incidence in the healthy population is low (0.7 per 100,000) but rises sharply in pregnancy, the immunocompromised and patients with malignancy. Listeria rarely causes mycotic aneurysm formation, with fewer than 40 cases reported in the literature. Further investigation revealed the patient to be diagnosed with a hepatocellular carcinoma. It is likely that the two pathologies were linked. Hence, we would advocate investigation for underlying malignancy in patients presenting with a mycotic aneurysm, particularly those resulting from Listeria infection.

Acute cholecystitis with Listeria monocytogenes.

Listeriosis, an opportunistic food-borne disease caused by Listeria monocytogenes, is infrequent and occurs preferentially in patients at the extremes of age, during pregnancy or in immunocompromised hosts. Most common manifestations are maternofoetal and neonatal infections, severe invasive presentations such as bacteraemia with or without central nervous system symptoms occuring preferentially in immunosuppressed patients and self-limited gastro-enteritis affecting healthy individuals. Exceptionally, focal infections such as cholecystitis are described. We report here a case of acute cholecystitis caused by Listeria monocytogenes in an 82-year-old woman. Thanks to a successful treatment: cholecystectomy and antimicrobial therapy (amoxicillin plus clavulanic acid), the patient soon recovered. This case-report provides an opportunity to review the current literature concerning the association of Listeria monocytogenes and cholecystitis.

[Listeria infection of a prosthetic hip joint]. / Listeriový infekt umelé kloubní náhrady.

A 74-year-old male with type 2 diabetes, coronary artery disease with history of CABG, hypertension and chronic obstructive pulmonary disease had total left hip replacement in another medical facility five years prior to admission. Since the early postoperative period, he had manifestations of dormant infection and was with empirical antibiotics. On the index admission, his X-ray showed signs of loosening of the prosthetic components with resorption of the bone. Periprosthetic infection was managed by a two-stage surgery. First, the infected prosthesis was removed and replaced with a spacer with antibiotics. One month later, a revision prosthesis, was implanted using cement with antibiotics. Cultures of the excised tissues and materials yielded massive growth of Listeria monocytogenes and scarce growth of Staphylococcus epidermidis. This is the 18th published case of arthroplasty infection caused by Listeria. The presented patient most likely had dormant staphylococcal infection on which Listeria superinfection developed and accelerated the loosening. A literature review suggested several mechanisms that can make conservative management of Listeria infection difficult. They include marked stimulation of the immune system (with resulting resorption of the bone), survival in the macrophages (unavailability to antibiotics susceptible in vitro) and capability to form biofilm as well as settle in biofilms produced by other organisms. Better yield and reliability of microbiological investigations may be achieved by guided intrarticular fluid aspiration from a microincision, prolonged culture and sonification of the extracted material, two-step surgical management and follow-up intraarticular fluid aspiration prior to reimplantation of revision prosthesis.

Absceso cerebral del adulto por Listeria monocytogenes: presentación de 6 casos y revisión de la literatura médica / Brain abscess due to Listeria monocytogenes in adults: Six cases and review of the literature

Introducción Listeria monocytogenes es un bacilo grampositivo, con especial tropismo por el sistema nervioso central (SNC). El absceso cerebral por Listeria es una entidad insuficientemente conocida, a pesar de que representa el 10% de las infecciones del SNC por este microorganismo. Métodos A continuación se presentan 6 pacientes con absceso cerebral por L. monocytogenes que ingresaron de forma consecutiva en el Hospital Universitario de Bellvitge durante los últimos 7 años. Se revisa también la literatura médica de los últimos 40 años hallando 70 pacientes con absceso cerebral por Listeria. Se describen las características epidemiológicas, clínicas, microbiológicas, radiológicas y evolutivas. Resultados El absceso cerebral por Listeria es una entidad de mal pronóstico y con elevada mortalidad. Conclusión Se requiere un elevado índice de sospecha para su detección precoz y tratamiento antibiótico correcto que redunde en una mejor evolución. La sospecha debe fundamentarse en la presencia de fiebre o febrícula junto con focalidad neurológica, sobre todo en pacientes inmunodeprimidos o diabéticos (AU)

Introduction Listeria monocytogenes is a gram-positive bacillus, with special tropism for the central nervous system (CNS). Brain abscess caused by Listeria has not been extensively studied, although it accounts for 10% of CNS infections due to this microorganism. Methods We present 6 patients with Listeria brain abscess consecutively admitted to Bellvitge University Hospital over the last 7 years. A literature review covering 40 years retrieved 70 patients with Listeria brain abscess. The epidemiologic, clinical, microbiological, and radiological findings related to this entity, and the outcome features are described. Results Brain abscess due to Listeria has a poor prognosis and is associated with elevated mortality. Conclusion A high index of suspicion is needed to reach an early diagnosis and establish appropriate antibiotic treatment, which will improve the outcome of this condition. Suspicion is based on the presence of fever and neurological symptoms, particularly in immunodepressed or diabetic patients (AU)

[Brain abscess due to Listeria monocytogenes in adults: six cases and review of the literature]. / Absceso cerebral del adulto por Listeria monocytogenes: presentación de 6 casos y revisión de la literatura médica.

INTRODUCTION: Listeria monocytogenes is a gram-positive bacillus, with special tropism for the central nervous system (CNS). Brain abscess caused by Listeria has not been extensively studied, although it accounts for 10% of CNS infections due to this microorganism. METHODS: We present 6 patients with Listeria brain abscess consecutively admitted to Bellvitge University Hospital over the last 7 years. A literature review covering 40 years retrieved 70 patients with Listeria brain abscess. The epidemiologic, clinical, microbiological, and radiological findings related to this entity, and the outcome features are described. RESULTS: Brain abscess due to Listeria has a poor prognosis and is associated with elevated mortality. CONCLUSION: A high index of suspicion is needed to reach an early diagnosis and establish appropriate antibiotic treatment, which will improve the outcome of this condition. Suspicion is based on the presence of fever and neurological symptoms, particularly in immunodepressed or diabetic patients.

Rare pediatric cardiac tumor presentation.

A case of cardiac inflammatory pseudotumor with a unique presentation is reported. This especially rare case belongs to a subset of pseudotumor caused by an infectious etiology. Furthermore, it is unique in that the patient experienced unexplained sinus tachycardia, which resolved with resection of the tumor. This report also emphasizes the importance of multiple imaging methods combined with the usefulness of surgery for treatment and diagnosis.

[Listeria monocytogenes prosthetic joint infection: Case report and review of the literature]. / Infección de prótesis articular por Listeria monocytogenes: caso clínico y revisión de la literatura médica.

INTRODUCTION: Listeria monocytogenes is an unusual pathogenic agent in the general population, but is an important cause of bacteriemia and meningoencephalitis among newborns, pregnant women, the elderly population, and immunosuppressed patients. In rare cases, it has been described in joint prosthesis infections. METHODS: A case description of prosthetic joint infection caused by Listeria in a 74-year-old man is presented. A systematic review of the literature (MEDLINE up to November 2007) was performed, and the reported cases are summarized. RESULTS: Sixteen cases of prosthetic joint infection by L. monocytogenes have been reported, mainly in patients of advanced age (mean, 67.4 years; mode, 70 years) and immunosuppressed patients. Most cases were late infections. CONCLUSION: L. monocytogenes should be kept in mind as a pathogen involved in joint prosthesis infection, particularly among the elderly and immunosuppressed populations. Based on the literature review, parenteral ampicillin for at least 6 weeks is the treatment of choice. If possible, prosthesis removal should also be performed.

Listeria monocytogenes sclerokeratitis: a case report and literature review.

PURPOSE: To report a case of Listeria monocytogenes sclerokeratitis and to review the literature. METHODS: Case report. RESULTS: A 25-year-old non-contact lens-wearing male rugby player was referred with progressive infective sclerokeratitis unresponsive to topical antivirals and antibiotics. On examination, visual acuity was perception of light, and a large corneal abscess with overlying epithelial defect and hypopyon was present. The corneal lesion was cheesy white and raised with nasal scleritis. This raised the suspicion of a fungal keratitis. Empirical treatment with intensive topical antifungals was unsuccessful. A previous corneal scrape had been negative for bacteria and fungi. A corneal biopsy was performed, and Listeria monocytogenes was eventually isolated from enrichment culture. Antibiotic sensitivities showed it to be resistant to cefuroxime, methicillin, and ceftazidime but sensitive to all other antibiotics tested including ofloxacin. The treatment course was complicated by a corneal perforation that needed an emergency therapeutic penetrating keratoplasty. Five months later, best-corrected visual acuity was 6/9 + 4, with a clear functioning graft. CONCLUSIONS: Listeria monocytogenes is a rare cause of corneal/scleral infection in humans. It often runs an aggressive course and responds poorly to initial intensive antibiotic treatment despite favorable in vitro sensitivities. It can be difficult to culture, and we suggest a corneal biopsy with extended incubation to improve diagnostic yield.

Early invasive Listeria monocytogenes infection after orthotopic liver transplantation: case report and review of the literature.

Infection with Listeria monocytogenes is rare, with a reported annual incidence of 4.4 cases per million individuals. It is caused by a gram-positive rod-shaped bacterium (Listeria monocytogenes) that can be found in soil, vegetation, water, sewage, and silage and in feces of humans and animals. It is a facultative intracellular pathogen with the ability to survive and multiply in phagocytic host cells, even in adverse environmental circumstances. Listeriosis has rarely been reported after orthotopic liver transplantation, and transplant physicians are often unfamiliar with the clinical presentation of this rare but virulent infection, which accounts for 20%-30% mortality in affected individuals. We present a case of invasive Listeria infection causing bacteremia and peritonitis in the early postoperative period after cadaveric liver transplantation in a previously asymptomatic patient.

Chronic-contained rupture of an infected aneurysm of the abdominal aorta due to Listeria monocytogenes.

We report a case of chronic-contained rupture of an infected aneurysm of the abdominal aorta, from which Listeria monocytogenes was cultured. The diagnosis of rupture and retroperitoneal mass was made by computed tomography, whereas FDG -PET diagnosed vessel wall inflammation. The infectious nature only became apparent at surgery.

[Listeria endophthalmitis]. / Listerien-Endophthalmitis.

Listeria monocytogenes is a rare cause of endogenous endophthalmitis. During the last 20 years about 30 cases have been published, all of which showed similar clinical features and a profound visual loss mainly owing to delayed diagnosis. This case report is about an otherwise healthy 41-year-old woman whose diagnosis was established 17 days after the onset of symptoms by microbiological cultures. Under sufficient therapy signs of local inflammation disappeared and intraocular pressure decreased. Pars plana vitrectomy was necessary; although post-surgery complications developed, the result was complete recovery of visual acuity.

[Listeria monocytogenes endophthalmitis]. / Endogene Endophthalmitis, verursacht durch Listeria monocytogenes.

PURPOSE: Listeria monocytogenes is a rare cause of endogenous endophthalmitis. Controversy exists concerning clinical progress and prognosis in this bacterial infection. However, only a few reports about the clinical features have been previously published in the literature. CASE REPORT: The case of a 24-year-old woman is reported. She developed an endogenous endophthalmitis within 3 weeks. The patient received a pars-plana vitrectomy showing Listeria monocytogenes in the vitreous body. An intensive antibiotic therapy was initiated (local, subconjunctival, intravitreal and systemic). Visual acuity was increased from hand motion to 0.5 by the end of the clinical attendance and to 1.0 three months later. There were no hints concerning systemic manifestation of listeriosis or granuloma formation. CONCLUSION: Frequently, endogenous endophthalmitis has a very poor prognosis. However, the presented case report describes a very prosperous progress of endogenous endophthalmitis caused by an infection with Listeria monocytogenes.

Rapidly enlarging iliac aneurysm secondary to listeria monocytogenes infection: a case report.

Infected aneurysms caused by Listeria monocytogenes are rare. Worldwide, 16 cases have been reported, none in the iliac system. The authors report the case of an 80-year-old man being followed for small aortic and right common iliac artery (RCIA) aneurysms who presented with progressive gastrointestinal symptoms. Serial computed tomography demonstrated a 200% increase in RCIA diameter with development of infection over 1 month. Right axillobifemoral bypass and aneurysm resection were performed. The authors believe this case represents the first description of bacteremic seeding of an iliac degenerative aneurysm by Listeria monocytogenes. The natural history and aggressive course of vascular infection with this organism are documented.

Epidural abscess and vertebral osteomyelitis caused by Listeria monocytogenes: case report and literature review.

A 69-y-old male with an epidural abscess and concomitant vertebral osteomyelitis caused by Listeria monocytogenes is presented, together with a brief review of the literature. To our knowledge, no cases of epidural abscess and only 3 cases of osteomyelitis have previously been reported in association with this organism.

Listeria endocarditis causing aortic root abscess and a fistula to the left atrium.

We report the case of a 74-year-old man who presented with endocarditis on a porcine aortic valve replacement. Five of six blood cultures grew listeria monocytogenes. Transoesophageal echocardiography demonstrated the presence of a cavity posterior to the aortic annulus, apparently communicating with the left atrium. The patient underwent successful aortic valve re-replacement. Listeria endocarditis is rare with only 58 reported cases in the literature and is associated with high mortality.