Listeria monocytogenes prosthetic joint infection: Two clinical cases and a review of the literature.

INTRODUCTION

Most infections caused by Listeria monocytogenes occur in individuals with predisposing conditions, such as advanced age or the use of immunosuppressive therapies, and primarily manifest as bacteremia or meningoencephalitis. Osteoarticular infections are uncommon and typically affect joint prostheses, with late-onset infections following surgery. Treatment in these cases should include antibiotic therapy along with a surgical strategy, which generally involves the removal of the affected prosthesis.

METHODS

Two cases of prosthetic joint infection caused by L. monocytogenes are presented, along with a narrative review of the English and Spanish literature via PubMed up to December 2024.

RESULTS

To the best of our knowledge, 52 cases of prosthetic joint infection caused by L. monocytogenes have been reported since 2000. All patients had predisposing conditions, with advanced age being the most common (mean age of 71 years). Most cases were late infections following surgery. Combined treatment (antibiotic therapy and surgery) was used in two-thirds of cases. The prognosis was favorable in almost all instances.

DISCUSSION: It is important to consider L. monocytogenes in the etiological diagnosis of prosthetic joint infections, especially in elderly or immunocompromised patients. While the most used antibiotics have been ampicillin and cotrimoxazole, oxazolidinones could serve as an oral alternative for the treatment of these infections.