Abstract

Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis of the liver. The organisms most commonly involved in this infection are gram-negative bacteria like Escherichia coli and Klebsiella pneumoniae, and gram-positive bacteria like Streptococcus pneumoniae and Staphylococcus aureus. Listeria monocytogenes is an uncommon gram-positive bacillus implicated in infections in neonates, pregnant females, the elderly, and immunocompromised patients. Listeria monocytogenes–induced SBP is rare, with less than 40 cases reported in the medical literature. Monobacterial non-neutrocytic bacterascites (MNB) is a variant of SBP, where the ascitic fluid culture is positive but the ascitic neutrophil count is less than 250/mm3. Forty percent of these patients will subsequently have SBP. Only 2 cases of MNB from L monocytogenes have previously been reported. We report a case of MNB in a patient with cirrhosis whose ascitic neutrophil count was 164/mm3, but Gram stain and microbiologic culture showed the growth of L monocytogenes.