Listeria monocytogenes peritonitis in cirrhotic patients. Value of ascitic fluid gram stain and a review of literature.
Listeria monocytogenes has been increasingly implicated in spontaneous bacterial peritonitis in patients with cirrhosis. This bacterium can be mistaken for diphtheroids and gram-positive cocci if special attention is not paid to the motility pattern and specific biochemical tests. Although the sensitivity of ascitic fluid Gram stain is low, we describe a case in which the Gram stain of the ascites fluid was positive. This issue is now pertinent given recent recommendations of third-generation cephalosporin antibiotics as empiric therapy for spontaneous bacterial peritonitis; Listeria is resistant to cephalosporin agents. A positive Gram stain could affect the empiric antibiotic therapy. We review the clinical presentation and outcome in nine other cases of Listeria peritonitis occurring in cirrhotic patients.
Nguyen
M H
MH
University of Pittsburgh School of Medicine, Pennsylvania 15261.
Yu
V L
VL
D000368:Aged; D001202:Ascitic Fluid / Q000382:microbiology*; D005840:Gentian Violet; D006801:Humans; D008088:Listeriosis / Q000175:diagnosis* / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications / Q000382:microbiology*; D008297:Male; D010538:Peritonitis / Q000453:epidemiology / Q000382:microbiology*; D010619:Phenazines; D013194:Staining and Labeling
C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet