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Listeriosis
Last reviewed: 08.11.2021
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Listeriosis (leaf laryosis, Tiger disease, neurellosis, neonatal granulomatosis) is an infectious disease of humans and animals caused by listeria, characterized by a variety of sources of infection, a variety of ways and factors of its transmission, polymorphism of clinical manifestations and high lethality.
Listeriosis is bacteremia, meningitis, cerebritis, dermatitis, oculo-glandular syndrome, intrauterine and neonatal infections, or, rarely, endocarditis caused by Listeria sp. Symptoms of listeriosis vary depending on which organ of the system is affected, and include an intrauterine fatal or perinatal infection. Treatment of listeriosis includes penicillin, ampicillin (often in combination with aminoglycosides) and trimethoprim-sulfamethoxazole.
ICD-10 codes
- A32. Listeriosis (listeriosis food infection).
- A32.0. Cutaneous listeriosis.
- A32.1. Listeriosis meningitis and meningoencephalitis.
- A32.7. Listeriosis septicemia.
- A32.8. Other forms (arthritis, endocarditis, glazosezelisty listeriosis).
- P37.2. Neonatal disseminated listeriosis.
What causes listeriosis?
Listeriosis is caused by listeria, which are small, non-colorable acidic dyes, non-spore forming, non-encapsulated, unstable, facultative anaerobes. They are found all over the world in the environment and intestines of mammals, birds, arachnids and crustaceans. There are several varieties of listeria, but L monocytogenes is the dominant pathogen in humans. The frequency of occurrence in the United States is 7 or more cases per 100,000 a year. There is a seasonal rise in the incidence of summer. The most frequent attacks are in newborns and adults aged 60 and over. Patients with immunosuppression fall into a high-risk group.
Infection usually occurs when eating contaminated dairy products, raw vegetables or meat. Infection is facilitated by the fact that L. Monocytogenes can survive and multiply in a refrigerator. Infection can also occur by direct contact and during the cutting of infected animals. Infection can be transmitted from mother to child during pregnancy and childbirth, as well as causing interruption of pregnancy.
What are the symptoms of listeriosis?
Primary listeriemia is rare and manifests a high fever, in which there are no local symptoms and signs. There may be endocarditis, peritonitis, osteomyelitis, cholecystitis and pleuropneumonia. Listeriemia can lead to intrauterine infection, chorionamionitis, premature birth, fetal death and infection of the newborn.
Meningitis caused by Listeria occurs in approximately 20% of cases in newborns and persons over 60 years of age. In 20% of cases, meningitis progresses to cerebritis or diffuse encephalitis, and, rarely, to rhombencephalitis and abscesses. The rhombencephalitis is manifested by impaired consciousness, paresis of the cranial nerves, cerebral signs, motor and sensory impairments.
Oculoglandular listeriosis can cause ophthalmia and an increase in regional lymph nodes. This disease may follow infection in the conjunctiva and, if untreated, may progress to bacteremia and meningitis.
How is listeriosis diagnosed?
Listeriosis is diagnosed by culturing blood samples or cerebrospinal fluid. The laboratory must be warned that there is a suspicion of L monocytogenes, because this microorganism is easily confused with diphtheria. In all infections caused by listeria, the IgG agglutinin titers reach a maximum of 2-4 weeks after the onset of the disease.
What tests are needed?
Who to contact?
How is listeriosis treated?
Meningitis caused by listeria is best treated with ampicillin at a dose of 2 g intravenously every 4 hours. Most authors recommend the use of aminoglycoside in addition to ampicillin, since in vitro these drugs act as synergists. Children are prescribed ampicillin 50-100 mg / kg intravenously every 6 hours. Cephalosporins are ineffective for the treatment of infections caused by listeria.
With endocarditis and primary listeriemia, listeriosis is treated with ampicillin at a dose of 2 g IV every 4 hours in combination with gentamicin (for synergistic effect) for 6 weeks (for endocarditis) and 2 weeks after the normalization of temperature (for listeriemia). Oculoglandular listeriosis and dermatitis due to listeria should be well treated with erythromycin at a dose of 10 mg / kg orally every 6 hours for up to 1 week after the temperature normalization. As an alternative, trimethoprim-sulfamethoxazole can be used at a dose of 5/25 mg / kg intravenously every 8 hours.
What is the prognosis of listeriosis?
Listeriosis has a favorable prognosis for glandular form and is serious in other forms.