CASE REPORT article
Front. Immunol.
Sec. Microbial Immunology
Case Report: Native Aortic Valve Listeria monocytogenes Endocarditis in an Adult with Evans Syndrome
Provisionally accepted
- 1Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- 2Kaohsiung Medical University, Kaohsiung, Taiwan
- 3Chung Hwa University of Medical Technology, Tainan City, Taiwan
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Background: Listeria monocytogenes is an uncommon cause of infective endocarditis but is associated with a high morbidity and mortality rate in immunocompromised hosts. Evans syndrome, typically treated with prolonged high-dose corticosteroids and additional immunosuppressants, may predispose patients to severe opportunistic infection. Case Presentation: A 44-year-old man with Evans syndrome on prednisolone and azathioprine, and with recent disseminated cryptococcosis, presented with acute right upper quadrant abdominal pain after ingesting oyster-containing street food. The patient did not exhibit any fever or neurological symptoms. Laboratory tests showed leukocytosis, thrombocytopenia, elevated inflammatory markers, and mild renal and hepatic dysfunction. Abdominal computed tomography (CT) findings were unremarkable. Empirical cefoperazone/sulbactam was initiated for suspected intra-abdominal infection and escalated to meropenem because of clinical deterioration. Blood cultures subsequently grew Listeria monocytogenes, prompting a de-escalation to high-dose intravenous ampicillin, resulting in rapid symptomatic improvement. Transthoracic and transesophageal echocardiography revealed multiple small, oscillating vegetations on the native aortic valve, consistent with infective endocarditis, without heart failure or embolic complications. The patient completed a 6-week course
Keywords: Bacteremia, case report, corticosteroids, Evans syndrome, Immunosuppression, Infective endocarditis, Listeria monocytogenes
Received: 20 Dec 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Wei, Lee, Liu, Yen, Lin and Tsai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jih-Jin Tsai
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