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
Listeriosis can present in different ways depending on the type of infection, such as: fever, headacheand muscle aches, sometimes preceded by diarrhea or other gastrointestinal symptoms. Other less common symptoms may include: stiff neck, confusion and convulsions. It has an incubation period which can range from a median of 24 hours, in Listeria gastroenteritis, to a median of 35 days, in Listeria invasive disease. Manifestations of listeriosis are host-dependent. 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 their newborns. Immunocompetent persons may experience acute febrile gastroenteritis or no symptoms.
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. 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 carriers of listeriosis, others become symptomatic. Depending on the affected systems, symptoms might include:
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. There may also be an encephalic component present, which will present with focal neurological signs, such as:
- Cranial nerve abnormalities
- Ataxia
- Tremors
- Hemiplegia
- Deafness
- Seizures
Cerebritis/ Encephalitis
In these cases, the clinical picture is dominated by altered consciousness and cognitive disfunction, but may also manifest as:[4]
Rhombencephalitis
Rhombencephalitis often follows a biphasic course, beginning with:
Which lasts for about 4 days, and 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.