Listeria monocytogenes and spondylodiscitis : a review of literature and presentation of a clinical case.

Abstract

We report a case of spondylodiscitis caused by Listeria monocytogenes (Lm) and conducted a literature review to compare therapeutic approaches. As Lm is a very uncommon pathogen that causes spondylodiscitis, its management is still up for debate. A 71-year-old man was referred to the hospital with low back pain and unexplained biological inflammatory syndrome. Blood culture revealed Lm bacteremia; intravenous amoxicillin monotherapy was therefore initiated. MRI showed L5-S1 spondylodiscitis associated with an anterior epidural phlegmon, a pathology rarely caused by Lm. In the absence of neurological symptoms, gentamicin was not added. Following a positive clinical response achieved through three weeks of intravenous therapy, oral regimen with trimethoprim-sulfamethoxazole was prescribed for an additional three weeks. This short course of parenteral antibiotherapy allowed earlier discharge with good safety and tolerance. In the absence of treatment guidelines for Lm spondylodiscitis, this successful approach highlights the possibility of an earlier switch to oral treatment.