Listeria Monocytogenes Workup

  • Author: Karen B Weinstein, MD, FACP; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Jan 17, 2012
 

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

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Contributor Information and Disclosures
Author

Karen B Weinstein, MD, FACP  Clinical Assistant Professor, Department of Internal Medicine, Loyola University; Assistant Attending, Department of Internal Medicine, Rush Medical College; Associate Program Director, West Suburban 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, and Illinois State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mark R Wallace, MD, FACP, FIDSA  Clinical Professor of Medicine, Florida State University College of Medicine; Head of Infectious Disease Fellowship Program, Orlando Regional Medical Center

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

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

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

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, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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Table. Epidemic Listeriosis
YearLocationSource
2011United StatesCantaloupe
2007MassachusettsMilk
2003United KingdomSandwiches
2002[13] United States (nationwide)Delicatessen turkey breast
August 1998 to January 1999Multiple states in the United StatesHot dogs, deli meats
1997[3] ItalyCorn
1997[14] SwedenRainbow trout
1995[15] SwitzerlandSoft cheese
1994[16] IllinoisChocolate milk
1992[17] FranceRillettes (pork product)
1985[18] CaliforniaMexican-style soft cheese
1983[19] New EnglandUnpasteurized milk
1981[20] CanadaColeslaw
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