title: Peritonitis as the First Presentation of Disseminated Listeriosis in a Patient on Peritoneal Dialysis-a Case Report.
abstract: Infections withListeria monocytogenesare uncommon but serious, with mortality rate approaching 30% in cases of systemic involvement despite first-line therapy. They are usually caused by ingestion of contaminated foods, but spontaneous infections have also been described.Listeria monocytogenesis a rare cause of peritonitis, and most of the published cases are in patients with cirrhosis and ascites. There are a few reported cases ofListeriaperitonitis associated with peritoneal dialysis (PD), primarily isolated peritonitis.If detected early,Listeriaperitonitis can be successfully treated with ampicillin, alone or in combination with gentamicin. Vancomycin has been listed as a second-line agent. However, it has been associated with treatment failure.In this case report, we present a patient who developed disseminated listeriosis, with peritonitis as the first manifestation of disseminated infection. This case illustrates the importance of having a high index of suspicion forL. monocytogenesif patients deteriorate despite empiric therapy for PD-associated peritonitis and serves as a further example demonstrating the inadequate coverage of vancomycin forL. monocytogenes.
authors.affiliation: Department of Medicine, The Ottawa Hospital, Affiliated with the University of Ottawa Faculty of Medicine, Ottawa, ON, Canada wbeckerleg@toh.ca.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Beckerleg
authors.affiliation: Department of Medicine, The Ottawa Hospital, Affiliated with the University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.|Division of Nephrology, The Ottawa Hospital, Affiliated with the University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Keskar
authors.affiliation: Department of Medicine, The Ottawa Hospital, Affiliated with the University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.|Division of Nephrology, The Ottawa Hospital, Affiliated with the University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Karpinski
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D008089:Listeria monocytogenes / Q000302:isolation & purification; D008088:Listeriosis / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents
keywords: Listeria monocytogenes; Peritoneal dialysis; peritonitis