title: Spontaneous Bacterial Peritonitis Caused by Infection with Listeria monocytogenes.
abstract: Spontaneous bacterial peritonitis is a severe and life-threatening complication in patients with ascites caused by advanced liver disease. The organisms most commonly involved are coliform bacteria and third-generation cephalosporins are the empiric antibiotics of choice. This is an uncommon case of spontaneous bacterial peritonitis caused by Listeria monocytogenes in a female patient with liver cirrhosis from autoimmune hepatitis. She did not improve with ceftriaxone and her course was complicated by hepatic encephalopathy, seizures and multi-organ failure. This case emphasizes that a high index of suspicion should be maintained for timely diagnosis and treatment. Listerial peritonitis should be suspected in patients with end-stage liver disease and inadequate response to conventional antibiotics within 48-72 h. Ampicillin/sulbactam should be initiated while awaiting results of ascitic fluid or blood culture.
authors.affiliation: Department of Internal Medicine, University of Connecticut Health Center, Farmington, Conn., USA.
authors.forename: Michael Vincent F
authors.initials: MV
authors.lastname: Tablang