Listeria monocytogenes rarely can present as an acute bacterial peritonitis.
Patients at risk:
(1) cirrhosis with ascites
(2) peritoneal dialysis
(3) liver transplant
(4) ventriculoperitoneal shunt
(5) primary pulmonary hypertension
(6) immunocompromised status
The diagnosis should be suspected in a patient with risk factors for listeriosis who does not improve within 24-48 hours after starting antibiotics.
A Gram stain can be helpful to identify small Gram-positive bacilli and to exclude common causes of peritonitis..
Culture may be required to definitively identify the organism.
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Specialty: Infectious Diseases, Nutrition
