Listeriosis in patients with connective tissue diseases.
OBJECTIVE
Patients with connective tissue diseases (CTD) are prone to infections, either from the disease itself or secondary to treatment. The incidence of listeriosis in immunosuppressed patients is increasing. We therefore evaluated the frequency of listeriosis, an otherwise rarely reported infection in the rheumatologic literature, in patients with CTD.


METHODS
Retrospective analysis of listeria positive cultures in patients with CTD between 1982 and 1992 at a tertiary care center in Mexico City.


RESULTS
We identified 8 patients: 7 with systemic lupus erythematosus and one with dermatomyositis. At the time of the infection, 5 had active disease, 6 were receiving prednisone and/or other immunosuppressive drugs and 2 were receiving hemodialysis. L. monocytogenes was isolated from cerebrospinal fluid (5 patients), from blood (one patient) and from both sites (2 patients). Patients had bacteremia without a known focus of infection or meningitis as the 2 most common clinical forms of listeriosis. In spite of appropriate antibiotic therapy, 4 patients died.


CONCLUSIONS
As in other immunosuppressed individuals, listeriosis is an aggressive infection in patients with CTD. Although rare, listeriosis should be included in the differential diagnosis of meningitis in patients with CTD and appropriate aggressive therapy rapidly instituted. To determine its frequency in rheumatic patients, multicentric prospective studies are required.
Department of Immunology, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City, Mexico.
A
A
Kraus
A R
AR
Cabral
J
J
Sifuentes-Osornio
D
D
Alarcón-Segovia
D000328:Adult; D000368:Aged; D003240:Connective Tissue Diseases / Q000150:complications*; D003882:Dermatomyositis / Q000150:complications; D005260:Female; D006801:Humans; D008088:Listeriosis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008584:Meningitis, Listeria / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies