308 LISTERIA MONOCYTOGENES INFECTIONS IN THE SOUTHERN CALIFORNIA DESERT

Purpose of Study L. monocygenes is a microorganism with a wide host range. Human infection ordinarily presents with bacteremia or meningitis in over 75% of those with listeriosis in the USA. The Coachella Valley of California is a desert community of more than 300,000 persons and is a retirement and tourist site for its 8 adjacent municipalities. Eisenhower Medical Center (EMC) provides medical services to a large segment of this population. In the past 20 years listerial infection was diagnosed in 14 patients. Only 4 of 14 patients (27%) presented solely with a bacteremia or meningitis.MethodsFourteen patients with listeriosis were studied with respect to the source of their infections. Four demonstrated arterial infections including 3 abdominal aortic aneurysms and 1 infected prosthetic femoral-popliteal by-pass graft. Three patients presented with multiple brain abscesses and 2 patients were diagnosed with septic synovitis Of the 4 patients with bacteremia, 1 had hairy cell leukemia 1, multiple myeloma and a third systemic lupus erythematosus. Only 1 patient with meningitis and 1 parturient bacteremic female lacked any underlying disease.Summary of Results Listeria monocytogenes in the Southern California desert presents in an entirely different manner than generally appreciated throughout the USA. Endarteritis, multiple brain abscesses, and septic synovitis are the presenting symptoms in individuals older than 60 years with such concurrent diseases as neoplasms, rheumatoid arthritis, lupus erythematosus, diabetes often utilizing immunosuppressive drugs. Despite the complexities of these illnesses, mortality was seen in 2 patients with endarteritis and in 2 with multiple brain abscesses (total = 4/14 = 27%)ConclusionsFourteen patients with listerial infections were seen at EMC in the Southern California desert, primarily a retirement and tourist group of municipalities. Twelve of 14 patients had underlying disorders and 9 presented with endarteritis, multiple brain abscesses, and septic synovitis. Most patients were elderly and immunocompromised.