Abstract
Spontaneous bacterial peritonitis (SBP) is a life-threatening complication in patients with ascites caused by advanced liver disease. While gram negative bacteria, such as Escherichia coli and Klebsiella pneumonia are the common pathogens, Listeria monocytogenes has been recognized as a very rare pathogen. Empirical treatment with third generation cephalosporins does not provide adequate antibiotics coverage against L. monocytogenes. Diagnosis is often delayed as it requires confirmation from ascitic fluid culture. Herein, we describe the first case of SBP caused by L. monocytogenes in a patient with advanced alcoholic liver cirrhosis in Korea. Clinicians should be aware of the atypical pathogens, especially in patients with inadequate response to empirical antibiotics.
References
1. Wiest R, Krag A, Gerbes A. Spontaneous bacterial peritonitis: recent guidelines and beyond. Gut. 2012; 61:297–310.
2. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010; 53:397–417.
3. Suk KT, Baik SK, Yoon JH, et al. Korean Association for the Study of the Liver. Revision and update on clinical practice guideline for liver cirrhosis. Korean J Hepatol. 2012; 18:1–21.
4. Cardoso C, Cremers I, Oliveira AP. Spontaneous bacterial peritonitis caused by Listeria monocytogenes: a case report and literature review. Ann Hepatol. 2012; 11:955–957.
5. Rheingold OJ, Chiprut RO, Dickinson GM, Schiff ER. Spontaneous peritonitis of cirrhosis due to Listeria monocytogenes. Ann Intern Med. 1977; 87:455–456.
6. Tandon P, Garcia-Tsao G. Bacterial infections, sepsis, and multi-organ failure in cirrhosis. Semin Liver Dis. 2008; 28:26–42.
7. Heo J, Seo YS, Yim HJ, et al. Clinical features and prognosis of spontaneous bacterial peritonitis in korean patients with liver cirrhosis: a multicenter retrospective study. Gut Liver. 2009; 3:197–204.
9. Limaye AP, Perkins JD, Kowdley KV. Listeria infection after liver transplantation: report of a case and review of the literature. Am J Gastroenterol. 1998; 93:1942–1944.
10. Nolla-Salas J, Almela M, Gasser I, Latorre C, Salvadó M, Coll P. Spontaneous Listeria monocytogenes peritonitis: a population-based study of 13 cases collected in Spain. Am J Gastroenterol. 2002; 97:1507–1511.
11. Mossey RT, Sondheimer J. Listeriosis in patients with long-term hemodialysis and transfusional iron overload. Am J Med. 1985; 79:397–400.
12. Liatsos GD, Thanellas S, Pirounaki M, Ketikoglou I, Moulakakis A. Listeria monocytogenes peritonitis: presentation, clinical features, treatment, and outcome. Scand J Gastroenterol. 2012; 47:1129–1140.
13. Jayaraj K, Di Bisceglie AM, Gibson S. Spontaneous bacterial peritonitis caused by infection with Listeria monocytogenes: a case report and review of the literature. Am J Gastroenterol. 1998; 93:1556–1558.