Listeria monocytogenes, an opportunistic organism commonly acquired from contaminated foods, is a particularly deadly cause of bacterial endocarditis. Although signs and symptoms vary, diagnosis is based on results of blood cultures and echocardiographic evidence of endocardial involvement. The author describes the development of Listeria endocarditis and the role of antibiotic treatment, and includes a case study.

Endocarditis due to Listeria monocytogenes is an uncommon bacterial infection.1 From 1955 until the end of 1996, only 58 cases had been reported.2 Despite the low prevalence, L monocytogenes is a deadly cause of endocarditis. In untreated cases, the mortality rate is 100%.2 Even with treatment, the mortality rate is 37%, compared with 14% for all types of bacterial endocarditis.3 Treatment ranges from aggressive antibiotic therapy to surgery. Although numerous antibiotic regimens have been used, ampicillin, often augmented by gentamicin, is recommended.1,4,5 A serious dilemma occurs when...

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