Listeria monocytogenes Spontaneous Bacterial Peritonitis Associated With Dissemination and Fatal Meningoencephalitis in a COVID-19 Co-infected Cirrhotic Patient: A Case Report and Literature Review

Listeria monocytogenes (LM) is a food-borne pathogen that can cause severe invasive infections, particularly in immunocompromised or elderly patients. Bacterial co-infections are frequently reported in COVID-19 patients, with both COVID-19-induced immune dysregulation and immunosuppressive therapies such as corticosteroids specifically creating risk for more unusual pathogens such as LM. We report a case of a 78-year-old woman with underlying cirrhosis due to non-alcoholic steatohepatitis who presented with fever and weakness, tested positive for COVID-19, and rapidly developed evidence of LM peritonitis with bacteremia and meningoencephalitis after dexamethasone initiation. Clinicians should maintain a high index of suspicion for listeriosis in acutely encephalopathic or septic patients with risk factors, especially during the COVID-19 era and in those receiving immunosuppressive therapy.