Diagnosis and Treatment of Listeria monocytogenes Endophthalmitis: A Systematic Review.
OBJECTIVE
Describe patient characteristics, treatment, and vision outcomes of Listeria monocytogenes endophthalmitis, an exceedingly rare form of listeriosis.


METHODS
L. monocytogenes endophthalmitis cases in human adults, located through Medline (32) and from disease surveillance centers (11). L. monocytogenes conjunctivitis and keratitis were excluded.


RESULTS
Most cases occurred in 2000-2015 (22/43), and almost all in Europe or North America (40/43). Patients were a median 61 years, 57% male (24/42) and half were immunosuppressed. Median days from entering care to diagnosis was 8 (IQR = 5-17). Only four were exogenous infections. L. monocytogenes was identified in 31/35 of anterior eye fluid samples (89%). Antibiotic regimens varied markedly (mostly ≥3 drugs). At diagnosis, most were blind in the affected eye (85%, 28/33), only a third regained normal vision (12/36). Older patients had poorer outcomes.


CONCLUSIONS
Cases increased over time. Diagnostic delays were common and visual impairment often refractory to treatment, especially in older adults. The condition's rarity and variation in treatment makes it difficult to identify optimum therapy.
a Wits Reproductive Health and HIV Institute, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.
Matthew F
MF
Chersich
b European Centre for Disease Prevention and Control , Solna , Sweden.
Johanna
J
Takkinen
c Institut Pasteur, Inserm U1117, National Reference Center and WHO Collaborating Center Listeria , Biology of Infection Unit , Paris , France.|d Paris Descartes University, Sorbonne Paris Cité, Necker-Pasteur Infectiology Centre, Necker-Enfants Malades University Hospital, Institut Imagine , Assistance Publique-Hôpitaux de Paris , Paris , France.
Caroline
http://orcid.org/0000-0002-9375-3620
C
Charlier
c Institut Pasteur, Inserm U1117, National Reference Center and WHO Collaborating Center Listeria , Biology of Infection Unit , Paris , France.
Alexandre
A
Leclercq
e Department of Paediatrics, Division of Paediatric Cardiology , Chris Hani Baragwanath Academic Hospital , Soweto , South Africa.|f School of Clinical Medicine, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.
Paul E
PE
Adams
g Reference Microbiology, National Infection Service, Public Health England, UK.
Gauri
G
Godbole
h Crosshouse Hospital, NHS Ayrshire & Arran , UK.
Ursula
U
Altmeyer
i Epidemiology and Surveillance of Infectious Diseases , Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands.
Ingrid H M
IHM
Friesema
j Department of Communicable Diseases and Infection Control , Kalmar County Hospital , Kalmar, Sweden.
Lisa
http://orcid.org/0000-0002-5621-5655
L
Labbé Sandelin
k Department of Microbiology , Target Laboratory , Johannesburg , South Africa.
Lorna
L
Jenkin
l Department of Opthalmology , Arcispedale S. M. Nuova IRCCS, Reggio Emilia , Italy.
Luigi
L
Fontana
m Department of Clinical and Experimental Medicine , University of Parma , Parma, Italy.
Raffaella
R
Aldigeri
a Wits Reproductive Health and HIV Institute, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.
Francois
F
Venter
n Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.|o Centre for International Health, Burnet Institute , Melbourne , Australia.
Stanley M F
SMF
Luchters
c Institut Pasteur, Inserm U1117, National Reference Center and WHO Collaborating Center Listeria , Biology of Infection Unit , Paris , France.|d Paris Descartes University, Sorbonne Paris Cité, Necker-Pasteur Infectiology Centre, Necker-Enfants Malades University Hospital, Institut Imagine , Assistance Publique-Hôpitaux de Paris , Paris , France.
Marc
M
Lecuit
p Immunology Eye Unit, Department of Ophthalmology , Arcispedale S. M. Nuova IRCCS, Reggio Emilia , Italy.
Luca
http://orcid.org/0000-0001-7956-9950
L
Cimino
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D006801:Humans; D008089:Listeria monocytogenes / Q000302:isolation & purification*; D008088:Listeriosis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy
D000900:Anti-Bacterial Agents
Endophthalmitis; Listeria monocytogenes; ocular inflammation; systematic review