Listeriosis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
The clinical manifestation of listeriosis is host-dependent. Immunocompetent persons may experience acute febrile gastroenteritis or no symptoms. Among older adults and immunocompromised persons, the most common clinical presentations are septicemia and meningitis. Pregnant women may experience a mild flu-like illness, followed by fetal loss, or bacteremia and meningitis in the newborns.
History
The majority of cases of listeriosis are sporadic. Although the source is often unknown, contaminated food is the most common vehicle of transmission. Some patients may be transitory carriers of the bacteria without showing signs of the disease. Manifestation of listeriosis will depend on the overall health status of each patient. Once bacteria penetrate the gastrointestinal lining, it will travel through the bloodstream to otherwise aseptic sites, such as the CNS, the uterus, and sometimes the heart, being responsible for the conditions described below.
The mean incubation period for febrile gastroenteritis following listeriosis is 24h, however, this may range from 6h up to 10 days. In the case of the remaining invasive illnesses, the mean incubation period is 35 days, ranging from 1 up to 91 days.[1][2][3]
Symptoms
Although some patients may be transitory asymptomatic carriers of listeriosis, others become symptomatic. There is a variety of clinical presentations depending on the affected systems and the immune status of the host.
Febrile Gastroenteritis
Infection in Pregnancy
Sepsis of Unknown Origin
Bacteremia
CNS Infection
Meningoencephalitis
The clinical presentation can range from mild fever and mental status changes, to a more aggressive course with coma. Focal neurological signs might be present, such as:
- Cranial nerve abnormalities
- Ataxia
- Tremors
- Hemiplegia
- Deafness
- Seizures
Cerebritis/ Encephalitis
In cerebritis/encephalitis, the clinical picture is dominated by altered consciousness and cognitive dysfunction. Additional symptoms include:[4]
Rhombencephalitis
Rhombencephalitis often follows a biphasic course. The initial phase lasts for about 4 days and is characterized by the following symptoms:
The initial phase is followed by an abrupt onset of:
- Asymetrical cranial nerve palsies
- Ataxia
- Tremor
- Decreased consciousness
- Seizures
- Hemiparesis and/or hemisensory deficits
- Respiratory failure
References
- ↑ Ooi ST, Lorber B (2005). "Gastroenteritis due to Listeria monocytogenes". Clin Infect Dis. 40 (9): 1327–32. doi:10.1086/429324. PMID 15825036.
- ↑ Dalton CB, Austin CC, Sobel J, Hayes PS, Bibb WF, Graves LM; et al. (1997). "An outbreak of gastroenteritis and fever due to Listeria monocytogenes in milk". N Engl J Med. 336 (2): 100–5. doi:10.1056/NEJM199701093360204. PMID 8988887.
- ↑ Linnan MJ, Mascola L, Lou XD, Goulet V, May S, Salminen C; et al. (1988). "Epidemic listeriosis associated with Mexican-style cheese". N Engl J Med. 319 (13): 823–8. doi:10.1056/NEJM198809293191303. PMID 3137471.
- ↑ Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0-443-06839-9.