Epidemiology
Risk Factors
- Anti-TNF Therapy (see [[Anti-TNF Therapy]])
- Case series of 15 patients
- Murine studies implicate TNFα in the immune response to Listeria
- Relative Risk: infliximab >etanercept (no cases reported with adalimumab)
- Clinical Presentation: meningitis, bacteremia, septic arthritis (no reports of Listeria pneumonia)
[Slifman NR, Gershon SK, Lee JH, et al. Listeria monocytogenes infection as a complication of treatment with tumor necrosis factor alpha- neutralizing agents. Arthritis Rheum 2003; 48:319-324]
- Lymphoma (see [[Lymphoma]])
Etiology
- Listeria monocytogenes infection
Diagnosis
- FOB:
- Thoracentesis: may have empyema
- pH: decreased
- Chemistry: exudate
- GS: gram-positive rods
- Culture: Listeria usually can be cultured out by usual methods
- CXR/Chest CT Pattern
- Infiltrates:
- Pleural Effusion:
Clinical Presentations
- Pneumonia (see [[Pneumonia]])
- Pleural Effusion (see [[Pleural Effusion-Exudate]])
Treatment
- High-Dose PCN: treatment of choice
- Cephalosporins and Macrolides have limited activity against Listeria monocytogenes
References
- Rothe J, Lesslauer W, Lotscher H, et al. Mice lacking the tumour necrosis factor receptor 1 are resistant to TNF-mediated toxicity but highly susceptible to infection by Listeria monocytogenes. Nature 1993; 364:798-802
- Slifman NR, Gershon SK, Lee JH, et al. Listeria monocytogenes infection as a complication of treatment with tumor necrosis factor alpha- neutralizing agents. Arthritis Rheum 2003; 48:319-324