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Listeria Monocytogenes Infection (Listeriosis) Workup

  • Author: Karen B Weinstein, MD, FACP; Chief Editor: Burke A Cunha, MD  more...
 
Updated: Jun 29, 2015
 

Laboratory Studies

Blood cultures should be performed. Blood culture results are positive in 60-75% of patients with CNS infections.

Listeria demonstrates "tumbling motility" in wet mounts of cerebrospinal fluid (CSF). Listeria organisms are motile in wet mounts of CSF.

CSF Gram stain results are positive in less than 50% of patients. CSF analysis reveals pleocytosis, and CSF protein levels are moderately elevated. CSF glucose levels may be low, and if so, are associated with a poor prognosis.

Laboratory results that show diphtheroids should prompt heightened awareness for the possibility of Listeria infection, particularly in immunocompromised patients.

CSF culture findings are positive in nearly 100% of patients.

Serologic testing is not reliable.

Synovial fluid and/or prosthetic joint material should be cultured in cases of septic arthritis.

Stool cultures are neither sensitive nor specific.

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Imaging Studies

MRI is superior to CT scan for demonstrating CNS disease, especially in the brainstem.[11]

Transesophageal echocardiography should be performed if endocarditis is suspected.

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Procedures

Lumbar puncture should be performed if CSF infection is suspected.

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Contributor Information and Disclosures
Author

Karen B Weinstein, MD, FACP Associate Professor, Department of Internal Medicine, Rush University Medical Center

Karen B Weinstein, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, Illinois State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

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Electron micrograph of an artificially colored Listeria bacterium in tissue.
Table. Epidemic Listeriosis
Year Location Source
2014 United States Prepackaged caramel apples
2011 United States Cantaloupe
2007 Massachusetts Milk
2003 United Kingdom Sandwiches
2002[13] United States (nationwide) Delicatessen turkey breast
August 1998 to January 1999 Multiple states in the United States Hot dogs, deli meats
1997[3] Italy Corn
1997[14] Sweden Rainbow trout
1995[15] Switzerland Soft cheese
1994[16] Illinois Chocolate milk
1992[17] France Rillettes (pork product)
1985[18] California Mexican-style soft cheese
1983[19] New England Unpasteurized milk
1981[20] Canada Coleslaw
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