Listeria monocytogenes pericarditis in a chronically hemodialyzed patient

Listeria pericarditis in a lymphoma patient: Case report and literature review

We present a case of pericarditis with pericardial effusion secondary to Listeria monocytogenes. A 56-year-old man presented with signs of acute pericarditis, but with prior chronic lymphocytic leukemia treated with stem cell transplantation, chronic graft-versus-host disease, and a recent diagnosis of untreated diffuse large B-cell lymphoma. He developed cardiac tamponade requiring pericardiocentesis. Blood and pericardial cultures grew Listeria monocytogenes. He responded to ampicillin but later died from gram-negative sepsis. A systematic review found 10 other published English-language cases of pericarditis caused by Listeria. The most common risk factors were cirrhosis and malignancy. Only three patients survived both the listeriosis and their underlying infections. Listeria monocytogenes is a rare and often fatal cause of pericarditis, typically occurring in immunocompromised patients. Cultures showing gram-positive bacilli in the context of pericarditis in an immunocompromised patient should prompt consideration of this rare cause.

Listeria myopericarditis associated with right atrial mural thrombus: a case report

Background 

Pericarditis is a common cardiology presentation, most often due to a viral or idiopathic cause. Listeria as a cause of pericarditis is rare. Listeria is an infection that is readily treatable with antibiotics following accurate identification. Without adequate treatment, Listeria infection has a high mortality rate.

Case summary 

In this case, a fit and well 59-year-old man complained of headaches and fever to the emergency department (ED). He was provisionally diagnosed with giant cell arteritis (GCA) and commenced on management pathways for GCA. He represented to the ED with chest pain and electrocardiogram (ECG) changes suggestive of a clinical presentation of pericarditis. He received treatment for idiopathic pericarditis with no clinical resolution. Cardiac magnetic resonance imaging (MRI) showed myopericardial inflammation associated with a right atrial mural thrombus. After 2 weeks of poor treatment response, peripheral blood cultures grew Listeria monocytogenes and the patient responded well to antibiotic treatment. Repeat cardiac MRI after an extended course of antibiotics showed resolution of MRI signs.

Discussion 

This is a case of Listeria myopericarditis. Physicians should consider rarer causes of myopericarditis in treatment resistance cases. Cardiac MRI has utility in atypical or treatment resistant patients to assess myopericardial inflammation and response to treatment.

Fatal Listeria meningitis, endocarditis and pericarditis in a patient with haemochromatosis

A 65-year-old man with primary haemochromatosis was admitted because of fever and confusion. He was found to have bacteraemia and meningitis due to Listeria monocytogenes. Treatment with ampicillin plus tobramycin was instituted, and despite an initial improvement, the patient experienced an unfavourable course and died. At postmortem examination, tricuspid valve endocarditis and purulent pericarditis with tamponade were detected. Listeria monocytogenes grew in the culture of the pericardial fluid. Documentation of Listeria monocytogenes pericarditis is extremely rare, and data on the patient described and on seven published cases are reported.

Opportunistic Listeria pericardial effusion

A case is described of pericardial effusion due to Listeria monocytogenes infection in a woman with advanced carcinoma of the cervix, rheumatoid arthritis and on corticosteroid therapy. Focal infection with listeria in immunocompromised adults has a high mortality unless promptly diagnosed. The correct diagnosis may have been made if an unexplained pericardial effusion had been tapped.

Listeria monocytogenes endocarditis in a patient on chronic hemodialysis, successfully treated with vancomycin-gentamicin

A case of Listeria monocytogenes endocarditis occurring as a complication of a vascular access infection in a patient on chronic hemodialysis that was successfully treated with a combination of vancomycin and gentamicin is reported. The difficulties in the diagnosis and treatment of L. monocytogenes infections, especially endocarditis, in patients on chronic hemodialysis are discussed.