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==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 monocytogenes|Listeria]]'' has an [[incubation period]] that can range from a median of 24 hours, in ''[[Listeria monocytogenes|Listeria]]'' [[gastroenteritis]], to a median of 35 days, in ''[[Listeria monocytogenes|Listeria]]'' invasive disease.<ref name="pmid15825036">{{cite journal| author=Ooi ST, Lorber B| title=Gastroenteritis due to Listeria monocytogenes. | journal=Clin Infect Dis | year= 2005 | volume= 40 | issue= 9 | pages= 1327-32 | pmid=15825036 | doi=10.1086/429324 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15825036 }} </ref><ref name="pmid8988887">{{cite journal| author=Dalton CB, Austin CC, Sobel J, Hayes PS, Bibb WF, Graves LM et al.| title=An outbreak of gastroenteritis and fever due to Listeria monocytogenes in milk. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 2 | pages= 100-5 | pmid=8988887 | doi=10.1056/NEJM199701093360204 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8988887  }} </ref><ref name="pmid3137471">{{cite journal| author=Linnan MJ, Mascola L, Lou XD, Goulet V, May S, Salminen C et al.| title=Epidemic listeriosis associated with Mexican-style cheese. | journal=N Engl J Med | year= 1988 | volume= 319 | issue= 13 | pages= 823-8 | pmid=3137471 | doi=10.1056/NEJM198809293191303 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3137471  }} </ref>  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==
==Symptoms==
*A person with listeriosis usually has [[fever]] and [[muscle ache]]s, sometimes preceded by [[diarrhea]] or other gastrointestinal symptoms. Almost everyone who is diagnosed with listeriosis has "invasive" infection, in which the bacteria spread beyond the gastrointestinal tract. The symptoms vary with the infected person:
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.<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>
===Febrile Gastroenteritis===
* [[Fever]]
* [[Watery diarrhea]]
* [[Nausea]]
* [[Vomiting]]
* [[Abdominal pain]]
* [[Headache]]
* [[Sore throat]]
* [[Arthralgia|Joint]] and [[myalgia|muscle pain]]
 
===Infection in Pregnancy===
* [[Fever]]
* [[Chills]]
* [[Back pain]]
 
===Sepsis of Unknown Origin===
* [[Fever]]
* [[Chills]]
* [[Malaise]]
 
===Bacteremia===
* [[Fever]]
* [[Myalgias]]
* [[Nausea]]
* [[Diarrhea]]


:*Pregnant women: Pregnant women typically experience only a mild, flu-like illness. However, infections during pregnancy can lead to [[miscarriage]], [[stillbirth]], [[premature delivery]], or life-threatening infection of the newborn.
===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:<ref name="pmid8592552">{{cite journal |vauthors=Southwick FS, Purich DL |title=Intracellular pathogenesis of listeriosis |journal=N. Engl. J. Med. |volume=334 |issue=12 |pages=770–6 |year=1996 |pmid=8592552 |doi=10.1056/NEJM199603213341206 |url=}}</ref>
*[[Cranial nerve]] abnormalities, most commonly [[Sixth nerve palsy|6th]] and [[Facial palsy|7th cranial nerve palsies]]
*Abnormal [[gait]] ([[ataxia]])
*[[Tremors]]
*[[Weakness]] of one side of the body ([[hemiplegia]])
*[[Deafness]]
*Abnormal movements ([[seizures]])


:*Persons other than pregnant women: Symptoms, in addition to fever and muscle aches, can include [[headache]], [[stiff neck]], [[confusion]], loss of balance, and [[convulsions]].
====Cerebritis/ Encephalitis====
In [[cerebritis]]/[[encephalitis]], the clinical picture is dominated by altered [[consciousness]] and [[cognitive]] dysfunction.  Additional symptoms include:<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>
*[[Fever]]
*[[Headache]]
*[[Hemiplegia]]


*Listeriosis can present in different ways depending on the type of infection. Manifestations of listeriosis are host-dependent. In older adults and persons with immunocompromising conditions, [[septicemia]] and meningitis are the most common clinical presentations. 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.
====Rhombencephalitis====
Rhombencephalitis often follows a biphasic course. The initial phase lasts for about 4 days and is characterized by the following symptoms:
*[[Headache]]
*[[Fever]]
*[[Nausea]]
*[[Vomiting]]
 
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==
==References==
{{reflist|2}}
{{reflist|2}}


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Latest revision as of 22:31, 29 July 2020

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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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