Listeria monocytogenes peritonitis in cirrhotic patients: first description in Brazil.
Two cases of spontaneous bacterial peritonitis (SBP) caused by Listeria monocytogenes in cirrhotic patients are reported. In one of the cases, the microorganism was isolated from pleural effusion and ascites. SBP is a serious and common complication of patients with ascites caused by hepatic cirrhosis and the culture of the ascitic fluid is an important tool for the diagnosis and for the more appropriate treatment. Although a third generation cephalosporin has usually been employed for empiric treatment of SBP, it does not provide adequate coverage against Listeria spp. In such cases the use of ampicillin (with or without sulbactam) or sulfamethoxazole-trimethoprim is recommended. The last one is used for secondary prophylaxis, instead of norfloxacin. To summarize, Listeria monocytogenes infection is a rare cause of SBP, whose treatment should be specific for the bacteria.
Toyoshima
Marcos Tadashi Kakitani
MT
Department of Internal Medicine, Hospital das Clínicas, S. Paulo University Medical School, S. Paulo, SP, Brazil. mtkt@terra.com.br
Apanavicius
André
A
de Matos Soeiro
Alexandre
A
de Almeida
Gisele Madeira Duboc
GM
Arai
Milton Hideaki
MH
D000368:Aged; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001201:Ascites / Q000150:complications*; D001202:Ascitic Fluid / Q000382:microbiology; D001938:Brazil; D005260:Female; D006801:Humans; D008089:Listeria monocytogenes / Q000302:isolation & purification*; D008088:Listeriosis / Q000175:diagnosis / Q000188:drug therapy; D008103:Liver Cirrhosis / Q000150:complications*; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D010996:Pleural Effusion / Q000382:microbiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination