Acute Graft Thrombosis and Aortic Root Pseudoaneurysm Associated With Listeria Bacteremia

Abstract

Listeria monocytogenes is an increasingly recognized cause of human diseases, especially in the immunocompromised host. Vascular infections involving Listeria remain relatively rare. In addition, Listeria vascular infections and Listeria endocarditis appear to be slightly different entities. We report the case of a 50-year-old man with steroid-dependent systemic lupus erythematosis who presented with Listeria bacteremia occurring with acute axillobifemoral graft thrombosis and an aortic root pseudoaneurysm. Following thrombectomy and graft revision, the patient was successfully treated with a 6-week course of intravenous antibiotics. The authors review Listeria vascular infections published to date and compare them with L. monocytogenes endocarditis cases published in the literature. Only 18 Listeria vascular infections have been previously reported. Major risk factors include age over 50 years, arteriosclerosis, hypertension, and diabetes. Most cases can be managed with surgical resection and/or graft revision followed by extended antibiotic therapy. Ampicillin or trimethoprim-sulfamethoxazole are the drugs of choice in treating these infections.