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| ==Overview== | | ==Overview== |
| For symptomatic patients, diagnosis is confirmed only after isolation of ''Listeria monocytogenes'' from a normally sterile site, such as blood, spinal fluid (in the setting of nervous system involvement), or amniotic fluid/placenta (in the setting of pregnancy). Importantly, a negative culture does not rule out infection in the presence of strong clinical suspicion. Serological tests exist but they are unreliable and not recommended at the present time.
| | Additional studies for the diagnosis of listeriosis are not recommended. |
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| ==Other Laboratory Studies== | | ==Other Laboratory Studies== |
| ===CSF Analysis===
| | Additional studies for the diagnosis of listeriosis are not recommended. |
| [[CSF]] analysis may lead to the confirmation of [[listeriosis]]. Common findings include:
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| * [[Pleocytosis]]
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| * More than 25 [[lymphocytes]] in [[CSF]] [[Differential blood count (patient information)|differential count]], without [[antibiotic]] therapy
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| * Moderately elevated [[CSF]] [[protein]] concentration with reduced [[CSF]] [[glucose]] concentration<ref name="pmid9772921">{{cite journal| author=Mylonakis E, Hohmann EL, Calderwood SB| title=Central nervous system infection with Listeria monocytogenes. 33 years' experience at a general hospital and review of 776 episodes from the literature. | journal=Medicine (Baltimore) | year= 1998 | volume= 77 | issue= 5 | pages= 313-36 | pmid=9772921 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9772921 }} </ref>
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| * Despite the name "monocytogenes", more that half the patients have increased levels of [[neutrophils]] in [[CSF]].
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| * [[Gram stain]] of the [[CSF]] has very low [[sensitivity]] and even when organisms are seen, they may be misidentified. <ref name="pmid4998254">{{cite journal| author=Lavetter A, Leedom JM, Mathies AW, Ivler D, Wehrle PF| title=Meningitis due to Listeria monocytogenes. A review of 25 cases. | journal=N Engl J Med | year= 1971 | volume= 285 | issue= 11 | pages= 598-603 | pmid=4998254 | doi=10.1056/NEJM197109092851103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4998254 }} </ref> Therefore, ''Listeria monocytogenes'' should always be considered when similar organisms are growing in [[blood culture |blood]] or [[CSF]] cultures. The presumptive diagnosis of [[viral meningitis]] should also be carefully considered in [[immunocompromised]], chronically ill, or elderly patients, presenting with acute [[meningitis]] and a negative [[Gram stain]]. In rhombencephalitis patients diagnosis is often delayed because [[CSF]] examination reveals only mild abnormalities.
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| * A [[polymerase chain reaction]] assay has been developed for the ''hly gene'' detection, which encodes for the ''listeriolysin O'', in [[CSF]] cultures. However, despite a high [[specificity]] and more [[sensitivity]], it is not commercially available yet.
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| ===Serodiagnosis===
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| [[Diagnosis]] of [[listeriosis]] with [[antibodies]] for ''[[listeriolysin O]]'' can be useful among [[infected]] patients with noninvasive disease.<ref>{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = 0-443-06839-9 | pages = }}</ref>
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
| [[Category:Bacterial diseases]]
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| [[Category:Disease]]
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| [[Category:Infectious disease]]
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| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |
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| | [[Category:Emergency mdicine]] |
| | [[Category:Disease]] |
| | [[Category:Up-To-Date]] |
| | [[Category:Infectious disease]] |
| | [[Category:Neurology]] |
| | [[Category:Gastroenterology]] |