SHM Converge Scientific Abstract ePoster Gallery-Listeria Bacteremia: Rare but Highly Fatal, Elderly Patient With Septic Shock

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This document describes <strong>Listeria monocytogenes infection</strong>, emphasizing its clinical significance in high-risk groups and presenting a severe case in an elderly patient.

Listeria is a <strong>gram-positive, facultative intracellular rod</strong> that often causes mild, self-limited gastroenteritis in healthy people. However, it can produce <strong>life-threatening disease</strong> in vulnerable populations, especially <strong>pregnant women, newborns, immunosuppressed patients, transplant recipients, the elderly, and people with impaired cell-mediated immunity</strong>. Serious complications include <strong>bacteremia/sepsis, meningitis, meningoencephalitis, endocarditis, pneumonia, and abscesses</strong>. Mortality is high, particularly in older or immunocompromised patients, and bloodstream infection carries an especially poor prognosis.

The case presented involves an <strong>84-year-old woman</strong> with a history of <strong>hypothyroidism, chronic dysphagia, inclusion body myositis, interstitial lung disease, pulmonary hypertension, and recurrent aspiration</strong>. She arrived with <strong>1 week of watery diarrhea, weakness, fevers, and chills</strong>, worsening over 4 days. In the emergency department she had <strong>fever, hypotension, and signs of dehydration</strong>. Initial tests showed <strong>elevated troponin and BNP</strong>, but normal lactate; chest X-ray suggested <strong>pulmonary congestion</strong>.

During hospitalization, she rapidly deteriorated with <strong>septic shock</strong>, tachycardia, tachypnea, and worsening hemodynamics. <strong>Blood cultures and PCR confirmed Listeria monocytogenes</strong> in both sets. She developed <strong>new atrial fibrillation, severely reduced ejection fraction (25–29%)</strong>, and required <strong>ampicillin, IV fluids, vasopressors, and intubation</strong> before transfer to the ICU. Despite aggressive treatment, her condition worsened, and the family chose <strong>comfort care</strong> after discussion of her wishes.

The case highlights that <strong>Listeria can be deadly in elderly patients</strong>, especially those with aspiration risk or exposure to improperly stored food, and underscores the importance of <strong>early recognition and prompt treatment</strong>.

Asset Subtitle

Roop Parlapalli

Meta Tag

Author List Amit Sharma MD, Chandu Siripuram, Mariyam Rafla Hassan, Roop Parlapalli, Sidrah Khan, Venu Gopal Kankani

Category Clinical Vignettes

Concept Listeria monocytogenes

Concept Listeriosis

Concept Older Adult

Concept Immunocompromised State

Concept Bacteremia

Distinguished Non-Finalist

Presenter Organization Geisinger

Presenting Author Roop Parlapalli

Track Adult

Keywords

Listeria monocytogenes

listeriosis

septic shock

elderly patient

immunocompromised

bacteremia

meningitis

ampicillin

foodborne infection

high-risk groups

Listeria monocytogenes

Listeriosis

Older Adult

Immunocompromised State

Bacteremia