Peritoneal dialysis-relatedListeria monocytogenesperitonitis treated with both intravenous and intraperitoneal ampicillin

Abstract

Listeria monocytogenesis a ubiquitous bacterium and opportunistic pathogen for immunocompromised patients. Peritoneal dialysis-relatedL. monocytogenesperitonitis is a rare clinical presentation, with a total of 23 cases reported to date and an overall mortality rate of 17.3%. The current report describes a case of peritoneal dialysis-relatedL. monocytogenesperitonitis in a woman in her 60s on long-term immunosuppressive therapies for a prior renal transplant. We treated this patient successfully with intraperitoneal ampicillin (125 mg/L in dialysate), in addition to intravenous ampicillin (1 g every 12 hours) for 10 days and subsequent oral amoxicillin 500 mg every 12 hours to complete a total 21-day course of therapy. This treatment regimen was informed by a literature review of pre-existing case studies, which demonstrated considerable variability in recommended antimicrobial dosing and frequency. A summary of this literature review is included in the current case report.