Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case report
Introduction: Listeria monocytogenes is a formidable pathogen that poses a significant threat to immunocompromised and might cause rare atypical forms of the disease especially complicated with Staphylococcus aureus coinfection. Case: We present a case of a patient with L. monocytogenes meningoencep...
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Elsevier
2025-01-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024169320 |
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| author | Roberta Vaikutyte-Ramanauskiene Danguole Vaznaisiene |
| author_facet | Roberta Vaikutyte-Ramanauskiene Danguole Vaznaisiene |
| author_sort | Roberta Vaikutyte-Ramanauskiene |
| collection | DOAJ |
| description | Introduction: Listeria monocytogenes is a formidable pathogen that poses a significant threat to immunocompromised and might cause rare atypical forms of the disease especially complicated with Staphylococcus aureus coinfection. Case: We present a case of a patient with L. monocytogenes meningoencephalitis, endocarditis, sepsis, and S. aureus osteomyelitis, highlighting the complexities of managing disseminated polymicrobial infection. A 64-year-old female with multiple myeloma treated with chemotherapy presented with fever, altered mental status, nausea, and diarrhea to the emergency department. During the physical examination, the patient was feverish, had a hemorrhagic rash and an abscess on the right thumb. Neurologically – nuchal rigidity was seen and the finger-nose test was abnormal. Blood tests and cerebrospinal fluid analysis were consistent with bacterial meningitis. The roentgenogram revealed osteomyelitis involving the right thumb. Later L. monocytogenes was identified in blood and cerebrospinal fluid cultures. The abscess was drained, and pus culture identified S. aureus. Echocardiography revealed vegetation on the aortic valve. The patient was initially treated with ceftriaxone, ampicillin, gentamicin, with clindamycin and ciprofloxacin for osteomyelitis and later with ampicillin/sulbactam and ciprofloxacin to cover both pathogens and pathologies. Due to an allergic reaction to ampicillin, treatment was changed to vancomycin. After 4 weeks of antibiotic therapy patient fully recovered and continued chemotherapy for multiple myeloma. Conclusion: In conclusion, this case emphasizes the intersection of hematological malignancy, chemotherapy-related immunosuppression, and subsequent severe disseminated bacterial infections and coinfections. Prompt diagnosis and adequate treatment of the disease and its complications is key to the successful recovery. |
| format | Article |
| id | doaj-art-72ee0de428254634be3034cf782dcbd3 |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-72ee0de428254634be3034cf782dcbd32025-01-17T04:49:52ZengElsevierHeliyon2405-84402025-01-01111e40901Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case reportRoberta Vaikutyte-Ramanauskiene0Danguole Vaznaisiene1Lithuanian University of Health Sciences, Faculty of Medicine, A.Mickeviciaus street, 9, LT-44307, Kaunas, Lithuania; Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, LT-47116, Kaunas, Lithuania; Corresponding author. Mickeviciaus str. 9, Kaunas, LT 44307, Lithuania.Lithuanian University of Health Sciences, Faculty of Medicine, A.Mickeviciaus street, 9, LT-44307, Kaunas, Lithuania; Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, LT-47116, Kaunas, LithuaniaIntroduction: Listeria monocytogenes is a formidable pathogen that poses a significant threat to immunocompromised and might cause rare atypical forms of the disease especially complicated with Staphylococcus aureus coinfection. Case: We present a case of a patient with L. monocytogenes meningoencephalitis, endocarditis, sepsis, and S. aureus osteomyelitis, highlighting the complexities of managing disseminated polymicrobial infection. A 64-year-old female with multiple myeloma treated with chemotherapy presented with fever, altered mental status, nausea, and diarrhea to the emergency department. During the physical examination, the patient was feverish, had a hemorrhagic rash and an abscess on the right thumb. Neurologically – nuchal rigidity was seen and the finger-nose test was abnormal. Blood tests and cerebrospinal fluid analysis were consistent with bacterial meningitis. The roentgenogram revealed osteomyelitis involving the right thumb. Later L. monocytogenes was identified in blood and cerebrospinal fluid cultures. The abscess was drained, and pus culture identified S. aureus. Echocardiography revealed vegetation on the aortic valve. The patient was initially treated with ceftriaxone, ampicillin, gentamicin, with clindamycin and ciprofloxacin for osteomyelitis and later with ampicillin/sulbactam and ciprofloxacin to cover both pathogens and pathologies. Due to an allergic reaction to ampicillin, treatment was changed to vancomycin. After 4 weeks of antibiotic therapy patient fully recovered and continued chemotherapy for multiple myeloma. Conclusion: In conclusion, this case emphasizes the intersection of hematological malignancy, chemotherapy-related immunosuppression, and subsequent severe disseminated bacterial infections and coinfections. Prompt diagnosis and adequate treatment of the disease and its complications is key to the successful recovery.http://www.sciencedirect.com/science/article/pii/S2405844024169320Listeria monocytogenesStaphylococcus aureusCoinfectionImmunocompromisedCase report |
| spellingShingle | Roberta Vaikutyte-Ramanauskiene Danguole Vaznaisiene Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case report Heliyon Listeria monocytogenes Staphylococcus aureus Coinfection Immunocompromised Case report |
| title | Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case report |
| title_full | Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case report |
| title_fullStr | Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case report |
| title_full_unstemmed | Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case report |
| title_short | Listeria monocytogenes and Staphylococcus aureus coinfection in a patient with multiple myeloma: Case report |
| title_sort | listeria monocytogenes and staphylococcus aureus coinfection in a patient with multiple myeloma case report |
| topic | Listeria monocytogenes Staphylococcus aureus Coinfection Immunocompromised Case report |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024169320 |
| work_keys_str_mv | AT robertavaikutyteramanauskiene listeriamonocytogenesandstaphylococcusaureuscoinfectioninapatientwithmultiplemyelomacasereport AT danguolevaznaisiene listeriamonocytogenesandstaphylococcusaureuscoinfectioninapatientwithmultiplemyelomacasereport |