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ALL / Infectious Diseases
Listeria
Listeria
Listeria monocytogenes is a Gram-positive bacillus which has the unusual ability to multiply at low temperatures. It is typically spread via contaminated food, typically unpasteurised dairy products. Infection is particularly dangerous to the unborn child where it can lead to miscarriage.Risk factors
- elderly
- neonates
- immunosuppression
- especially glucocorticoids
- pregnancy
Features - can present in a variety of ways
- gastroenteritis
- diarrhoea
- bacteraemia
- flu-like illness
- central nervous system infection
- meningoencephalitis
- ataxia
- seizures
Investigation
- blood cultures
- 'tumbling motility' on wet mounts
- cerebrospinal fluid findings:
- pleocytosis, often lymphocytes (nontuberculous bacteria usually cause a rise in neutrophils)
- raised protein
- reduced glucose
Management
- Listeria is sensitive to amoxicillin/ampicillin (cephalosporins usually inadequate)
- Listeria meningitis should be treated with IV amoxicillin/ampicillin and gentamicin
In pregnant women
- pregnant women are almost 20 times more likely to develop listeriosis compared with the rest of the population due to changes in the immune system
- fetal/neonatal infection can occur both transplacentally and vertically during childbirth
- complications include miscarriage, premature labour, stillbirth and chorioamnionitis
- diagnosis can only be made from blood cultures
- treatment is with amoxicillin
+PassMedicine Notes
Listeria monocytogenes is a Gram-positive bacillus which has the unusual ability to multiply at low temperatures. It is typically spread via contaminated food, typically unpasteurised dairy products. Infection is particularly dangerous to the unborn child where it can lead to miscarriage.
Risk factors- elderly
- neonates
- immunosuppression
- especially glucocorticoids
- pregnancy
- gastroenteritis
- diarrhoea
- bacteraemia
- flu-like illness
- central nervous system infection
- meningoencephalitis
- ataxia
- seizures
- blood cultures
- 'tumbling motility' on wet mounts
- cerebrospinal fluid findings:
- pleocytosis, often lymphocytes (nontuberculous bacteria usually cause a rise in neutrophils)
- raised protein
- reduced glucose
- Listeria is sensitive to amoxicillin/ampicillin (cephalosporins usually inadequate)
- Listeria meningitis should be treated with IV amoxicillin/ampicillin and gentamicin
- pregnant women are almost 20 times more likely to develop listeriosis compared with the rest of the population due to changes in the immune system
- fetal/neonatal infection can occur both transplacentally and vertically during childbirth
- complications include miscarriage, premature labour, stillbirth and chorioamnionitis
- diagnosis can only be made from blood cultures
- treatment is with amoxicillin
