Listeriosis classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Clinical syndromes caused by Listeria monocytogenes include: infection in pregnancy, neonatal infection, bacteremia, central nervous system infection (meningitis, encephalitis, rhombencephalitis, brain abscess, spinal cord infection), endocarditis, localized infection, and febrile gastroenteritis.
Classification
There are four common clinical syndromes:
- Infection in pregnancy: Listeria can proliferate asymptomatically in the vagina and uterus. If the mother becomes symptomatic, it is usually in the third trimester. Symptoms include fever, myalgias, arthralgias and headache. Abortion, stillbirth, and preterm labor are complications of genitourinary infection.
- Neonatal infection (granulomatosis infantisepticum): There are two forms. One, an early-onset sepsis, with Listeria acquired in utero, results in premature birth. Listeria can be isolated in the placenta, blood, meconium, nose, ears, and throat. Another, late-onset meningitis is acquired through vaginal transmission, although it also has been reported with caesarean deliveries.
- CNS infection: Listeria has a predilection for the brain parenchyma, especially the brain stem, and the meninges. Mental status changes are common. Seizures occur in at least 25% of patients. Cranial nerve palsies, encephalitis, meningitis, meningoencephalitis, or abscesses may occur.
- Gastroenteritis: Listeria monocytogenes can produce food-borne diarrheal disease, which typically is noninvasive. The median incubation period is 1-2 days, with diarrhea lasting anywhere from 1-3 days. Patients present with fever, muscle aches, nausea, diarrhea, headache, stiff neck, confusion, loss of balance, or convulsions.