Abstract:

Spontaneous bacterial peritonitis is a bacterial infection in ascitic fluid without a history of intra-abdominal surgery and is a fatal complication of ascites. Spontaneous bacterial peritonitis is usually diagnosed when a cirrhotic patient has abdominal pain or when a patient with cirrhosis decompensates, such as hepatorenal syndrome, or when routine paracentesis is performed. The diagnosis is established when the neutrophil count is ≥250/mm3. The causative microorganisms are often enteric Gram-negative bacteria. Spontaneous bacterial peritonitis is treated empirically, and the treatment can be revised according to the culture result. Listeria monocytogenes is a rare cause of spontaneous bacterial peritonitis. It is a Gram-positive facultative anaerobe bacillus that causes infections, particularly in neonates, the elderly, and immunocompromised individuals. Fever, a common finding of other infections, is not usually seen in patients with spontaneous bacterial peritonitis. In this case report, we present a case of a 67-year-old female hospitalized with complaints of ascites and peripheral edema and who was diagnosed with cryptogenic liver cirrhosis. Listeria monocytogenes grew in ascitic fluid recovered during empirical treatment due to fever. While the spontaneous bacterial peritonitis was being treated empirically, Listeria monocytogenes grew in ascites and blood cultures of the patient, who developed fever and recovered after a change in treatment. Although Listeria monocytogenes is a rare pathogen, factors, such as age and chronic disease, may increase its incidence, as in our case. Listeria monocytogenes should be considered in patients with spontaneous bacterial peritonitis who do not respond to empirical treatment or who show systemic symptoms, such as fever, during treatment.