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. 2017 Apr 10;5(2):2324709617698995.
doi: 10.1177/2324709617698995. eCollection 2017 Apr-Jun.

Listeria Endocarditis: A Diagnostic Challenge

Wilhelmina J A R M Valckx  1 , Suzanne P M Lutgens  1 , Hortence E Haerkens-Arends  1 , Peter C Barneveld  1 , Jaap J Beutler  1 , Ellen K Hoogeveen  1
Affiliations

Listeria Endocarditis: A Diagnostic Challenge

Wilhelmina J A R M Valckx et al. J Investig Med High Impact Case Rep. .

Abstract

A 74-year-old hemodialysis patient with a history of an atrial septum defect closure, coronary bypass surgery, and a St. Jude aortic prosthetic valve was diagnosed with pneumonia and volume overload. Blood cultures were positive for Listeria monocytogenes, and amoxicillin was given for 2 weeks. Immediately after discontinuation of amoxicillin, fever relapsed. Transthoracic and transesophageal echocardiography showed no sign of endocarditis. Given the fever relapse and 3 positive minor Duke criteria, an 18F-FDG PET-CT scan (18F-fluorodeoxyglucose-positron emission tomography-computed tomography) scan was performed. This scan showed activity at the aortic root, proximal ascending aorta, and inferior wall of the heart, making Listeria monocytogenes endocarditis a likely explanation. Amoxicillin was given for 6 weeks with good clinical result. Diagnosing a life-threatening Listeria monocytogenes endocarditis can be challenging and an 18F-FDG PET-CT scan can be helpful.

Keywords: 18F-FDG PET-CT scan; Listeria monocytogenes; endocarditis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Chest radiography Anteroposterior (left) and sagittal (right). The thin arrows point at the consolidation of the right upper lobe and the bold arrows point at the redistribution.
Figure 2.
Figure 2.
18F-FDG PET scan and CT scan Coronal view of the 18F-FDG PET in fusion with low dose CT (left) and only 18FDG PET (right) showing activity at the proximal ascending aorta (upper arrows), aortic root (middle arrows) and inferior wall of the heart (lower arrows).
See this image and copyright information in PMC

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