Sections

Listeria Monocytogenes Infection (Listeriosis)

Sections Listeria Monocytogenes Infection (Listeriosis)
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Medication
Questions & Answers
Tables
References

Presentation

History

L monocytogenes infection may be a self-limited gastrointestinal tract illness or a more severe CNS infection, bacteremia, or a localized infection such as monoarticular septic arthritis.

Physical

Examination depends on the organ system involved.

Listeriosis in Pregnancy

Listeria may proliferate in the placenta and cause infection due to impaired cell-mediated immunity during pregnancy.

CNS infection is very rare during pregnancy, although it is observed frequently in other compromised hosts.

Fever, myalgias, arthralgias, back pain, and headache are classic symptoms of bacteremia. Symptoms may mimic those of a flulike illness. The infection may be mild and self-limited.

Listeriosis during pregnancy usually occurs during the third trimester, when cell-mediated immunity is at its lowest.

Preterm labor and/or delivery is common. Abortion, stillbirth, and intrauterine infection are possible.

Neonatal infection (granulomatosis infantisepticum)

Two forms are described.^[8]

Early-onset sepsis, with Listeria acquired in utero via transplacental transmission, results in premature birth. Listeria can be isolated in the placenta, blood, meconium, nose, ears, and throat, among other sites, and manifests as abscesses and/or granulomas.

Late-onset meningitis is acquired through vaginal transmission, although it also has been reported with cesarean deliveries.

CNS infection

Listeria has a predilection for the brain parenchyma, especially the brain stem, and the meninges.

Mental status changes are common.

Seizures, both focal and generalized, occur in at least 25% of patients.

Cranial nerve deficits may be present.

Strokelike syndromes with hemiplegia may occur.

Nuchal rigidity is less common.

Movement disorders may include tremor, myoclonus, and ataxia.

Patients may present with encephalitis, especially of the brainstem.^[9]

Meningitis is possible.

Ventriculitis, particularly of the fourth ventricle, may develop.

Cervical myelitis has been reported.^[10]

Brain abscess occurs in 10% of CNS infections, often located in the thalamus, pons, and medulla. This uncommon complication is associated with high mortality.^[11]

Febrile gastroenteritis

L monocytogenes can produce food-borne diarrheal disease, which is typically noninvasive.

The median incubation period is 1-2 days, with diarrhea lasting anywhere from 1-3 days.

The prevalence of diarrheal illness is high in individuals exposed to inocula of Listeria.

Patients present with fever, myalgias, and diarrhea and recover with supportive care.

Causes

Most infections are due to food-borne transmission.

A substantial minority of infections are transmitted by other modes. Transmission can occur transplacentally or via an infected birth canal. Isolated incidences of cross-infection in neonatal nurseries have been reported.

Nosocomial infection, while rare, has been reported.

Differential Diagnoses

Khsim IEF, Mohanaraj-Anton A, Horte IB, Lamont RF, Khan KS, Jørgensen JS, et al. Listeriosis in pregnancy: An umbrella review of maternal exposure, treatment and neonatal complications. BJOG. 2022 Aug. 129 (9):1427-1433. [QxMD MEDLINE Link].
Rogalla D, Bomar PA. Listeria Monocytogenes. 2022 Jan. [QxMD MEDLINE Link]. [Full Text].
Mook P, O'Brien SJ, Gillespie IA. Concurrent conditions and human listeriosis, England, 1999-2009. Emerg Infect Dis. 2011 Jan. 17(1):38-43. [QxMD MEDLINE Link].
Ooi ST, Lorber B. Gastroenteritis due to Listeria monocytogenes. Clin Infect Dis. 2005 May 1. 40(9):1327-32. [QxMD MEDLINE Link].
Aureli P, Fiorucci GC, Caroli D, Marchiaro G, Novara O, Leone L, et al. An outbreak of febrile gastroenteritis associated with corn contaminated by Listeria monocytogenes. N Engl J Med. 2000 Apr 27. 342(17):1236-41. [QxMD MEDLINE Link].
Pappas G, Panagopoulou P, Christou L, Akritidis N. Category B potential bioterrorism agents: bacteria, viruses, toxins, and foodborne and waterborne pathogens. Infect Dis Clin North Am. 2006 Jun. 20(2):395-421, x. [QxMD MEDLINE Link].
Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, et al. Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis. 2011 Jan. 17 (1):7-15. [QxMD MEDLINE Link].
Mylonakis E, Paliou M, Hohmann EL, Calderwood SB, Wing EJ. Listeriosis during pregnancy: a case series and review of 222 cases. Medicine (Baltimore). 2002 Jul. 81(4):260-9. [QxMD MEDLINE Link].
Armstrong RW, Fung PC. Brainstem encephalitis (rhombencephalitis) due to Listeria monocytogenes: case report and review. Clin Infect Dis. 1993 May. 16(5):689-702. [QxMD MEDLINE Link].
Josephson SA, Pillai DR, Phillips JJ, Chou D. Neurolisteriosis presenting as cervical myelitis in an immunocompetent patient. Neurology. 2006 Apr 11. 66(7):1122-3. [QxMD MEDLINE Link].
Dee RR, Lorber B. Brain abscess due to Listeria monocytogenes: case report and literature review. Rev Infect Dis. 1986 Nov-Dec. 8(6):968-77. [QxMD MEDLINE Link].
Faidas A, Shepard DL, Lim J, Nelson JE, Baddour LM. Magnetic resonance imaging in listerial brain stem encephalitis. Clin Infect Dis. 1993 Jan. 16(1):186-7. [QxMD MEDLINE Link].
Charlier C, Leclercq A, Cazenave B, Desplaces N, Travier L, Cantinelli T, et al. Listeria monocytogenes-Associated Joint and Bone Infections: A Study of 43 Consecutive Cases. Clin Infect Dis. 2012 Jan. 54(2):240-8. [QxMD MEDLINE Link].
Gottlieb SL, Newbern EC, Griffin PM, Graves LM, Hoekstra RM, Baker NL, et al. Multistate outbreak of Listeriosis linked to turkey deli meat and subsequent changes in US regulatory policy. Clin Infect Dis. 2006 Jan 1. 42(1):29-36. [QxMD MEDLINE Link].
Ericsson H, Eklow A, Danielsson-Tham ML, Loncarevic S, Mentzing LO, et al. An outbreak of listeriosis suspected to have been caused by rainbow trout. J Clin Microbiol. 1997 Nov. 35(11):2904-7. [QxMD MEDLINE Link].
Büla CJ, Bille J, Glauser MP. An epidemic of food-borne listeriosis in western Switzerland: description of 57 cases involving adults. Clin Infect Dis. 1995 Jan. 20(1):66-72. [QxMD MEDLINE Link].
Dalton CB, Austin CC, Sobel J, Hayes PS, Bibb WF, Graves LM, et al. An outbreak of gastroenteritis and fever due to Listeria monocytogenes in milk. N Engl J Med. 1997 Jan 9. 336(2):100-5. [QxMD MEDLINE Link].
Goulet V, Rocourt J, Rebiere I, Jacquet C, Moyse C, Dehaumont P, et al. Listeriosis outbreak associated with the consumption of rillettes in France in 1993. J Infect Dis. 1998 Jan. 177(1):155-60. [QxMD MEDLINE Link].
Linnan MJ, Mascola L, Lou XD, Goulet V, May S, Salminen C, et al. Epidemic listeriosis associated with Mexican-style cheese. N Engl J Med. 1988 Sep 29. 319(13):823-8. [QxMD MEDLINE Link].
Schlech WF 3rd, Lavigne PM, Bortolussi RA, Allen AC, Haldane EV, Wort AJ, et al. Epidemic listeriosis--evidence for transmission by food. N Engl J Med. 1983 Jan 27. 308(4):203-6. [QxMD MEDLINE Link].
Evans JR, Allen AC, Stinson DA, Bortolussi R, Peddle LJ. Perinatal listeriosis: report of an outbreak. Pediatr Infect Dis. 1985 May-Jun. 4(3):237-41. [QxMD MEDLINE Link].
Lorber B. Listeriosis. Clin Infect Dis. 1997 Jan. 24(1):1-9; quiz 10-1. [QxMD MEDLINE Link].
Koopmans MM, Brouwer MC, Bijlsma MW, Bovenkerk S, Keijzers W, van der Ende A, et al. Listeria monocytogenes sequence type 6 and increased rate of unfavorable outcome in meningitis: epidemiologic cohort study. Clin Infect Dis. 2013 Jul. 57 (2):247-53. [QxMD MEDLINE Link].
Sheffield JS. Sepsis and septic shock in pregnancy. Crit Care Clin. 2004 Oct. 20(4):651-60; viii. [QxMD MEDLINE Link].
Mylonakis E, Hohmann EL, Calderwood SB. Central nervous system infection with Listeria monocytogenes. 33 years' experience at a general hospital and review of 776 episodes from the literature. Medicine (Baltimore). 1998 Sep. 77(5):313-36. [QxMD MEDLINE Link].
Cunha BA. Antibiotic Essentials. 7th ed. Royal Oak, MI: Physicians Press; 2008.
Armstrong D, Cohen J, eds. Listeria Monocytogenes. Infectious Diseases. London, UK: Mosby; 1999. 8.15.1-8.15.20.
Berenguer J, Solera J, Diaz MD, Moreno S, Lopez-Herce JA, Bouza E. Listeriosis in patients infected with human immunodeficiency virus. Rev Infect Dis. 1991 Jan-Feb. 13(1):115-9. [QxMD MEDLINE Link].
Blatt SP, Zajac RA. Treatment of Listeria bacteremia with vancomycin. Rev Infect Dis. 1991 Jan-Feb. 13(1):181-2. [QxMD MEDLINE Link].
Broome CV. Listeriosis: Can we prevent it?. ASM News. 1993. 59:444-6.
Calubiran OV, Horiuchi J, Klein NC, Cunha BA. Listeria monocytogenes meningitis in a human immunodeficiency virus-positive patient undergoing hemodialysis. Heart Lung. 1990 Jan. 19(1):21-3. [QxMD MEDLINE Link].
Chang J, Powles R, Mehta J, Paton N, Treleaven J, Jameson B. Listeriosis in bone marrow transplant recipients: incidence, clinical features, and treatment. Clin Infect Dis. 1995 Nov. 21(5):1289-90. [QxMD MEDLINE Link].
Charpentier E, Gerbaud G, Jacquet C, Rocourt J, Courvalin P. Incidence of antibiotic resistance in Listeria species. J Infect Dis. 1995 Jul. 172(1):277-81. [QxMD MEDLINE Link].
Cherubin CE, Appleman MD, Heseltine PN, Khayr W, Stratton CW. Epidemiological spectrum and current treatment of listeriosis. Rev Infect Dis. 1991 Nov-Dec. 13(6):1108-14. [QxMD MEDLINE Link].
Cunha BA. Central nervous system infections in the compromised host: a diagnostic approach. Infect Dis Clin North Am. 2001 Jun. 15(2):567-90. [QxMD MEDLINE Link].
Cunha BA, Fatehpuria R, Eisenstein LE. Listeria monocytogenes encephalitis mimicking Herpes Simplex virus encephalitis: the differential diagnostic importance of cerebrospinal fluid lactic acid levels. Heart Lung. 2007 May-Jun. 36(3):226-31. [QxMD MEDLINE Link].
Cunha BA, Filozov A, Remé P. Listeria monocytogenes encephalitis mimicking West Nile encephalitis. Heart Lung. 2004 Jan-Feb. 33(1):61-4. [QxMD MEDLINE Link].
Decker CF, Simon GL, DiGioia RA, Tuazon CU. Listeria monocytogenes infections in patients with AIDS: report of five cases and review. Rev Infect Dis. 1991 May-Jun. 13(3):413-7. [QxMD MEDLINE Link].
Farber JM, Peterkin PI. Listeria monocytogenes, a food-borne pathogen. Microbiol Rev. 1991 Sep. 55(3):476-511. [QxMD MEDLINE Link].
Gellin BG, Broome CV, Bibb WF, Weaver RE, Gaventa S, Mascola L. The epidemiology of listeriosis in the United States--1986. Listeriosis Study Group. Am J Epidemiol. 1991 Feb 15. 133(4):392-401. [QxMD MEDLINE Link].
Gorbach SL, Bartlett JB, Blacklow NR, eds. Listeria Monocytogenes. Infectious Diseases. 2nd ed. Philadelphia, Pa: WB Saunders; 1998. 1750-5.
Gross E, Slauson S. Update on emerging infections: news from the Centers for Disease Control and Prevention. Preliminary FoodNet Data on the incidence of infection with pathogens transmitted commonly through food--selected sites, United States, 2003. Ann Emerg Med. 2004 Nov. 44(5):532-6. [QxMD MEDLINE Link].
Hof H, Nichterlein T, Kretschmar M. Management of listeriosis. Clin Microbiol Rev. 1997 Apr. 10(2):345-57. [QxMD MEDLINE Link].
John JF. Listeria Monocytogenes. Vinken PJ, Bruyn GW, eds. Handbook of ClinicalNeurology. New York, NY: Elsevier Science; 1988. Vol 8: 89-101.
Klein NC, Schoch PE, Cunha BA. Listeria. Infect Control Hosp Epidemiol. 1991 May. 12(5):311-4. [QxMD MEDLINE Link].
Latcha S, Cunha BA. Listeria monocytogenes meningoencephalitis: the diagnostic importance of the CSF lactic acid. Heart Lung. 1994 Mar-Apr. 23(2):177-9. [QxMD MEDLINE Link].
Lorber B. Listeria Monocytogenes. Mandell GL, Bennett GE, Dolin R, eds. Principles and Practices of Infectious Diseases. 6th ed. Pennsylvania, PA: Churchill and Livingstone; 2005. 2478.
Pigrau C, Almirante B, Pahissa A, Gasser I, Martinez Vasquez JM. Clinical presentation and outcome in cases of listeriosis. Clin Infect Dis. 1993 Jul. 17(1):143-4. [QxMD MEDLINE Link].
Pinner RW, Schuchat A, Swaminathan B, Hayes PS, Deaver KA, Weaver RE, et al. Role of foods in sporadic listeriosis. II. Microbiologic and epidemiologic investigation. The Listeria Study Group. JAMA. 1992 Apr 15. 267(15):2046-50. [QxMD MEDLINE Link].
Riedo FX, Pinner RW, Tosca ML, Cartter ML, Graves LM, Reeves MW, et al. A point-source foodborne listeriosis outbreak: documented incubation period and possible mild illness. J Infect Dis. 1994 Sep. 170(3):693-6. [QxMD MEDLINE Link].
Schneider JI. Rapid infectious killers. Emerg Med Clin North Am. 2004 Nov. 22(4):1099-115. [QxMD MEDLINE Link].
Schuchat A, Robinson K, Wenger JD, Harrison LH, Farley M, Reingold AL, et al. Bacterial meningitis in the United States in 1995. Active Surveillance Team. N Engl J Med. 1997 Oct 2. 337(14):970-6. [QxMD MEDLINE Link].
Skogberg K, Syrjanen J, Jahkola M, Renkonen OV, Paavonen J, Ahonen J, et al. Clinical presentation and outcome of listeriosis in patients with and without immunosuppressive therapy. Clin Infect Dis. 1992 Apr. 14(4):815-21. [QxMD MEDLINE Link].
Spitzer PG, Hammer SM, Karchmer AW. Treatment of Listeria monocytogenes infection with trimethoprim-sulfamethoxazole: case report and review of the literature. Rev Infect Dis. 1986 May-Jun. 8(3):427-30. [QxMD MEDLINE Link].
Swaminathan B, Rocourt J, Bille J. Listeria. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. 6th ed. Washington, DC: ASM Press; 1995. 341-8.
Taege AJ. Listeriosis: recognizing it, treating it, preventing it. Cleve Clin J Med. 1999 Jun. 66(6):375-80. [QxMD MEDLINE Link].
Tappero JW, Schuchat A, Deaver KA. Reduction in the incidence of human listeriosis in the United States. Effectiveness of prevention efforts? The Listeriosis Study Group. JAMA. 1995 Apr 12. 273(14):1118-22. [QxMD MEDLINE Link].
Uldry PA, Kuntzer T, Bogousslavsky J, Regli F, Miklossy J, Bille J, et al. Early symptoms and outcome of Listeria monocytogenes rhombencephalitis: 14 adult cases. J Neurol. 1993. 240(4):235-42. [QxMD MEDLINE Link].
Walsh RD, Gurevich I, Cunha BA. Listeria: A potential cause of febrile transfusion reactions. J Hosp Infect. 1993. 18:81-82.
Lomonaco S, Nucera D, Filipello V. The evolution and epidemiology of Listeria monocytogenes in Europe and the United States. Infect Genet Evol. 2015 Oct. 35:172-83. [QxMD MEDLINE Link].
Nyarko EB, Donnelly CW. Listeria monocytogenes: Strain Heterogeneity, Methods, and Challenges of Subtyping. J Food Sci. 2015 Dec. 80 (12):M2868-78. [QxMD MEDLINE Link].
Leazer R, Perkins AM, Shomaker K, Fine B. A Meta-analysis of the Rates of Listeria monocytogenes and Enterococcus in Febrile Infants. Hosp Pediatr. 2016 Apr. 6 (4):187-95. [QxMD MEDLINE Link].
Calame DG, Mueller-Ortiz SL, Wetsel RA. Innate and adaptive immunologic functions of complement in the host response to Listeria monocytogenes infection. Immunobiology. 2016 Dec. 221 (12):1407-1417. [QxMD MEDLINE Link].

Media Gallery

Electron micrograph of an artificially colored Listeria bacterium in tissue.

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Sections Listeria Monocytogenes Infection (Listeriosis)
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Medication
Questions & Answers
Tables
References

Year	Location	Source
2022	United States	Ice cream
2021	United States	Pre-packaged salads
2017	South Africa	Processed meat product (polony)
2014	United States	Prepackaged caramel apples
2011	United States	Cantaloupe
2007	Massachusetts	Milk
2003	United Kingdom	Sandwiches
2002^[14]	United States (nationwide)	Delicatessen turkey breast
August 1998 to January 1999	Multiple states in the United States	Hot dogs, deli meats
1997^[5]	Italy	Corn
1997^[15]	Sweden	Rainbow trout
1995^[16]	Switzerland	Soft cheese
1994^[17]	Illinois	Chocolate milk
1992^[18]	France	Rillettes (pork product)
1985^[19]	California	Mexican-style soft cheese
1983^[20]	New England	Unpasteurized milk
1981^[21]	Canada	Coleslaw

Listeria Monocytogenes Infection (Listeriosis) Clinical Presentation

History

Physical

Listeriosis in Pregnancy

Neonatal infection (granulomatosis infantisepticum)

CNS infection

Febrile gastroenteritis

Causes

References

Tables

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