Recurrent, ICD-associated L. monocytogenes bacteraemia with multiple septic pulmonary embolisms over a 2-year period

TL;DR

A patient with a heart device had recurring Listeria infections over two years, highlighting the need to identify and remove foreign material sources of infection.

Contribution

This case study highlights the role of an ICD device as a persistent source of Listeria monocytogenes infection and the importance of comprehensive assessment in chronic cases.

Findings

The patient experienced six Listeria relapses over two years, with the ICD device identified as the infection source.

cgMLST analysis confirmed persistent Listeria monocytogenes, showing recurrence despite symptom resolution.

The case underscores the need for thorough investigations to prevent relapses in patients with foreign material.

Abstract

Listeria monocytogenes is a bacterial pathogen known for causing listeriosis, a foodborne illness with a wide spectrum of clinical presentations ranging from mild gastroenteritis to severe invasive disease, particularly affecting immunocompromised individuals, pregnant women, newborns, and the elderly. Successful treatment of patients with recurring listeria episodes due to colonised foreign material is often challenging, typically requiring a combination of antimicrobial treatment and surgical removal.

Here, we present a particularly complex case of chronic invasive listeriosis with a total of six relapses. After extensive investigations, the patient's ICD device was identified as the focus of infection.

The confirmation of relapses through cgMLST analysis highlights the persistence of Listeria monocytogenes and the potential for recurrence even after apparent resolution of symptoms in patients with foreign material. It emphasises the necessity for a comprehensive assessment to identify and mitigate the risk of relapses, thereby ensuring optimal management and outcomes.

The online version contains supplementary material available at 10.1007/s15010-024-02209-w.

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