Listeria monocytogenes Spontaneous Bacterial Peritonitis in a Patient With Decompensated Cirrhosis

Authors

• Leen M. Ahmed, Henry Ford Health
• Sara M. Farah, Henry Ford Health
• Layan Alali, Henry Ford Health
• Majd Hamzeh, Henry Ford Health
• Ahmed M. Saleh

Recommended Citation

Ahmed LM, Farah SM, Alali L, Hamzeh M, Saleh AM. Listeria monocytogenes Spontaneous Bacterial Peritonitis in a Patient With Decompensated Cirrhosis. Cureus 2025; 17(12):100155-100155.

Document Type

Article

Publication Date

12-1-2025

Publication Title

Cureus

Keywords

alcoholic cirrhosis; ampicillin; ascites; listeria monocytogenes; listeria sbp; spontaneous bacterial peritonitis (sbp)

Abstract

A 54-year-old man with decompensated alcohol-related cirrhosis presented with worsening abdominal pain, recurrent ascites, and acute kidney injury on chronic kidney disease. Initial diagnostic paracentesis showed a polymorphonuclear (PMN) count of 75 cells/μL, which lowered suspicion for spontaneous bacterial peritonitis (SBP). However, ascitic fluid culture subsequently isolated Listeria monocytogenes, a rare cause of SBP that is intrinsically resistant to third-generation cephalosporins. Empiric ceftriaxone would not provide reliable coverage. Therapy was escalated to high-dose intravenous ampicillin, with subsequent transition to oral trimethoprim-sulfamethoxazole to complete therapy, together with large-volume paracentesis, albumin supplementation, and supportive management of hepatorenal dysfunction. The patient improved clinically and biochemically and was discharged in stable condition. This case underscores the need to consider Listeria in cirrhotic patients who fail to respond to standard cephalosporin-based therapy and to promptly tailor antibiotics to culture results to optimize outcomes.

PubMed ID

41602264

Volume

17

Issue

12

First Page

100155

Last Page

100155