A Case of Pneumonia with Pleural Effusion Caused by Listeria monocytogenes

Tark Kim; Dae-Young Kim; Heungsup Sung; Mi-Na Kim; Sung-Han Kim; Sang-Ho Choi; Jun Hee Woo; Yang Soo Kim; Sang-Oh Lee

doi:10.3947/ic.2012.44.2.87

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Kim, Kim, Sung, Kim, Kim, Choi, Woo, Kim, and Lee: A Case of Pneumonia with Pleural Effusion Caused by Listeria monocytogenes

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(2): 87-91.

Published online: 30 April 2012

DOI: https://doi.org/10.3947/ic.2012.44.2.87

A Case of Pneumonia with Pleural Effusion Caused by Listeria monocytogenes

Tark Kim¹, Dae-Young Kim¹, Heungsup Sung², Mi-Na Kim², Sung-Han Kim¹, Sang-Ho Choi¹, Jun Hee Woo¹, Yang Soo Kim¹, Sang-Oh Lee¹

¹Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

²Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Correspondence to: Sang-Oh Lee. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3301, Fax: +82-2-3010-6970, soleemd@amc.seoul.kr

Received 29 December 2011 Revised 6 February 2012 Accepted 9 February 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Listeria monocytogenes is a facultative anaerobic gram positive rod bacteria that is wide spread in the natural environment and found in soil, water, decaying vegetation, and as part of the fecal flora of many mammals. It is also a common cause for meningoencephalitis and bacteremia in at-risk groups including neonates, pregnant women, elderly persons, and immunocompromised patients. However, pneumonia with pleuritis is a very rare manifestation of L. monocytogenes. We report a case of pneumonia with pleural effusion caused by L. monocytogenes as isolated from the blood culture of a patient diagnosed with acute lymphoblastic leukemia resulting from induction chemotherapy. The patient recovered after the introduction of therapeutic thoracentesis and administration of intravenous ampicillin (2 g q 6 hr) plus gentamicin (1.7 mg/kg q 8 hr) over a two week period. This case demonstrated that L. monocytogenesis infection should be a consideration in the differential diagnosis of pneumonia and pleuritis in leukemic patients.

Keywords: Listeria monocytogenes, Pneumonia, Pleural effusion

Figures and Tables

Figure 1

(A) Initial chest X-ray showed diffuse consolidation in the left lower lung field and atelectasis in the left upper lung field with left pleural effusion. (B) The follow-up chest X-ray taken 14 days after administration of ampicillin plus gentamicin revealed decreased consolidation and pleural effusion in the left lung field.

Figure 2

Initial chest non-contrast CT revealed (A) pneumonic consolidation and (B) pleural effusion in the left lung field.

Table 1

Case series of Pneumonia and Pleuritis caused by L. monocytogenes

AIDS, acquired immunodeficiency syndrome; L, lymphocyte; M, monocyte; N, neutrophil; NA, not available; PR, present report

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