Abstract
A 74-year-old hemodialysis patient with a history of an atrial septum defect closure, coronary bypass surgery, and a St. Jude aortic prosthetic valve was diagnosed with pneumonia and volume overload. Blood cultures were positive for Listeria monocytogenes, and amoxicillin was given for 2 weeks. Immediately after discontinuation of amoxicillin, fever relapsed. Transthoracic and transesophageal echocardiography showed no sign of endocarditis. Given the fever relapse and 3 positive minor Duke criteria, an 18F-FDG PET-CT scan (18F-fluorodeoxyglucose-positron emission tomography-computed tomography) scan was performed. This scan showed activity at the aortic root, proximal ascending aorta, and inferior wall of the heart, making Listeria monocytogenes endocarditis a likely explanation. Amoxicillin was given for 6 weeks with good clinical result. Diagnosing a life-threatening Listeria monocytogenes endocarditis can be challenging and an 18F-FDG PET-CT scan can be helpful.
Highlights
In the general population, the bacterium Listeria monocytogenes causes infections with an annual incidence of 0.32 cases per 100 000 inhabitants in Europe
We present a patient with an extraordinary diagnostic course of Listeria endocarditis, an infection affecting about 8% of the Listeriainfected adults.[3] supply, and a respiratory rate of 16/minute
Listeria monocytogenes is a facultative anaerobic, nonsporeforming gram-positive rod that can be isolated from soil, dust, animal feed, water, sewage, and the tissues or fluid of almost any type of animal
Summary
The bacterium Listeria monocytogenes causes infections with an annual incidence of 0.32 cases per 100 000 inhabitants in Europe. The clinical presentation and the presence of only 3 minor Duke criteria (one blood culture with an atypical microorganism, a predisposing heart condition, and fever), infective endocarditis was considered unlikely.
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