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Mizuno S, Zendejas IR, Reed AI, Kim RD, Howard RJ, Hemming AW, Schain DC, Soldevila-Pico C, Firpi RJ, Fujita S. Listeria monocytogenes following orthotopic liver transplantation: Central nervous system involvement and review of the literature. World J Gastroenterol 2007; 13(32): 4391-4393 [PMID: 17708617 DOI: 10.3748/wjg.v13.i32.4391]
World J Gastroenterol. Aug 28, 2007; 13(32): 4391-4393 Published online Aug 28, 2007. doi: 10.3748/wjg.v13.i32.4391
Listeria monocytogenes following orthotopic liver transplantation: Central nervous system involvement and review of the literature
Shugo Mizuno, Ivan R Zendejas, Alan I Reed, Robin D Kim, Richard J Howard, Alan W Hemming, Denise C Schain, Consuelo Soldevila-Pico, Roberto J Firpi, Shiro Fujita
Shugo Mizuno, Ivan R Zendejas, Alan I Reed, Robin D Kim, Richard J Howard, Alan W Hemming, Shiro Fujita, Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, FL 32610-0286, United States
Denise C Schain, Division of Infectious Disease, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610-0286, United States
Consuelo Soldevila-Pico, Roberto J Firpi, Division of Gastroenterology, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610-0286, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Shiro Fujita, MD, Department of Surgery, University of Florida College of Medicine, PO Box 100286, Gainesville, FL 32610-0286, United States. fujita@surgery.ufl.edu
Telephone: +1-352-2650606 Fax: +1-352-2650678
Received: April 26, 2007 Revised: May 5, 2007 Accepted: May 12, 2007 Published online: August 28, 2007
Abstract
Listeria monocytogene is a well-recognized cause of bacteremia in immunocompromised individuals, including solid organ transplant recipients, but has been rarely reported following orthotopic liver transplantation. We describe a case of listeria meningitis that occurred within a week after liver transplantation. The patient developed a severe headache that mimicked tacrolimus encephalopathy, and was subsequently diagnosed with listeria meningitis by cerebrospinal fluid culture. The infection was successfully treated with three-week course of intravenous ampicillin. Recurrent hepatitis C followed and was successfully treated with interferon alfa and ribavirin. Fourteen cases of listeriosis after orthotopic liver transplantation have been reported in the English literature. Most reported cases were successfully treated with intravenous ampicillin. There were four cases of listeria meningitis, and the mortality of them was 50%. Early detection and treatment of listeria meningitis are the key to obtaining a better prognosis.
