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

Fever is the most common symptom of listeriosis. Other symptoms develop on location of the infection: Patients with gastroenteritis may develop watery diarrhea, abdominal pain, vomiting, and headache. Patients with CNS infection may develop symptoms of meningitis, encephalitis, cerebritis, rhombencephalitis, or spinal cord infection, such as headache, back pain, neck pain, photophobia, phonophobia, deafness, confusion, ataxia, seizures, and neurological impairment.

History

Although the source is often unknown, contaminated food is the most common vehicle of transmission. Listeria has an incubation period that can range from a median of 24 hours, in Listeria gastroenteritis, to a median of 35 days, in Listeria invasive disease.[1][2][3] Patients who present with symptoms suggestive of listeriosis should be inquired about history of ingested of uncooked meats and vegetables, unpasteurized (raw) milk and cheeses, processed (or ready-to-eat) meats, and smoked seafood within the last few weeks.

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.[4]

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:[5]

Cerebritis/ Encephalitis

In cerebritis/encephalitis, the clinical picture is dominated by altered consciousness and cognitive dysfunction. Additional symptoms include:[6]

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:

References

  1. Ooi ST, Lorber B (2005). "Gastroenteritis due to Listeria monocytogenes". Clin Infect Dis. 40 (9): 1327–32. doi:10.1086/429324. PMID 15825036.
  2. 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.
  3. 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.
  4. 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.
  5. Southwick FS, Purich DL (1996). "Intracellular pathogenesis of listeriosis". N. Engl. J. Med. 334 (12): 770–6. doi:10.1056/NEJM199603213341206. PMID 8592552.
  6. 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.

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