Detailed Abstract
[E-poster]
[E09] Listeria Monocytogenes Endophthalmitis In Immunocompromised Patient
JaRyung HAN1 , Young Seok HAN*1
1 Liver Transplantation & Hepatobiliary Pancreas Surgery, Kyungpook National University Hospital, REPUBLIC OF KOREA
Background : Listeria monocytogenes is known for pathogen of enteritis. In severe case, Listeria infection can cause meningoencephalitis, corneal ulcer, pneumonia, endocarditis and intrauterine or cervical infections may result spontaneous abortion in immunocompromised patients and pregnant women. Listeria monocytogenes causing endophthalmitis was reported, the patient with RA, the other had previous Listeria gastroenteritis history, and the last one had no underlying disease and previous history.
Methods : A 58-year-old male underwent orthotopic liver transplantation(OLT) due to fulminant hepatic failure presented with hepatic encephalopathty and hepatorenal syndrome in July 2016. 2 years after the OLT, he received the two times of steroid pulse therapy (SPT) due to hyperbilirubinemia caused by acute cellular rejection. At 1 week after SPT, he complained of fever and chill without other symptoms. Listeria monocytogenes was isolated from a blood culture collected on the day when fever was observed. However, Follow-up blood culture revealed no growth of Listeria monocytogenes and his fever was also spontaneously regressed. At 1 month after SPT, he was presented with visual disturbance and ocular discomfort with discharge in the right eye. By ophthalmologists, anterior chamber paracentesis was performed to decrease intraocular pressure and they injected intravitreal antibiotics. They also performed culture during anterior chamber paracentesis for microbiological analysis.
Results : Microbiological analysis revealed Listeria monocytogenes infection. Intravenous antibiotics with intravitreal antibiotics injection(ampicllin-sulbactam, gentamicin) was administered for 1 week and immunosuppression was gradually decreased. Oral ampicillin-sulbactam was continued for 2 months after finishing intravenous antibiotics administration. Finally, he recovered without any complications.
Conclusions : Listeria monocytogenes infection may be invasive in the immunocompromised patients as above. Early diagnosis is key factor in treatment and outcomes of endophthalmitis caused by Listeria monocytogenes. An appropriate chamber paracentesis is important to diagnose, systemic antibiotics treatment should be considered.
Methods : A 58-year-old male underwent orthotopic liver transplantation(OLT) due to fulminant hepatic failure presented with hepatic encephalopathty and hepatorenal syndrome in July 2016. 2 years after the OLT, he received the two times of steroid pulse therapy (SPT) due to hyperbilirubinemia caused by acute cellular rejection. At 1 week after SPT, he complained of fever and chill without other symptoms. Listeria monocytogenes was isolated from a blood culture collected on the day when fever was observed. However, Follow-up blood culture revealed no growth of Listeria monocytogenes and his fever was also spontaneously regressed. At 1 month after SPT, he was presented with visual disturbance and ocular discomfort with discharge in the right eye. By ophthalmologists, anterior chamber paracentesis was performed to decrease intraocular pressure and they injected intravitreal antibiotics. They also performed culture during anterior chamber paracentesis for microbiological analysis.
Results : Microbiological analysis revealed Listeria monocytogenes infection. Intravenous antibiotics with intravitreal antibiotics injection(ampicllin-sulbactam, gentamicin) was administered for 1 week and immunosuppression was gradually decreased. Oral ampicillin-sulbactam was continued for 2 months after finishing intravenous antibiotics administration. Finally, he recovered without any complications.
Conclusions : Listeria monocytogenes infection may be invasive in the immunocompromised patients as above. Early diagnosis is key factor in treatment and outcomes of endophthalmitis caused by Listeria monocytogenes. An appropriate chamber paracentesis is important to diagnose, systemic antibiotics treatment should be considered.
SESSION
E-poster
E-Session 12/03 ALL DAY