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
Gram-positive rods:
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]])
Dyspnea:
Cough:
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
