Listeriosis: Difference between revisions

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==Overview==
==[[Listeriosis overview|Overview]]==
'''Listeriosis''' is a [[list of infectious diseases|bacterial infection]] caused by a [[gram-positive]], [[Motility|motile]] bacterium, ''[[Listeria monocytogenes]]''.<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref>  Listeriosis is relatively rare and occurs primarily in newborn infants, elderly patients, and patients who are [[immunocompromised]].<ref name=Baron>{{cite book | author = Hof H | title = Listeria Monocytogenes ''in:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | id = [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.973#982 (via NCBI Bookshelf)] ISBN 0-9631172-1-1 }}</ref>


==Epidemiology==
==[[Listeriosis classification|Classification]]==
Incidence is 4.4 cases per million population. Pregnant women account for 30% of all cases.<ref>Center for Infectious Disease Research & Policy, [[University of Minnesota]] - [http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/causes/listerioview.html Listeriosis]</ref> Of all nonperinatal infections, 70% occur in immunocompromised patients.


==Pathogenesis==
==[[Listeriosis historical perspective|Historical Perspective]]==
''L monocytogenes'' is ubiquitous in the environment. The main route of acquisition of ''Listeria'' is through the ingestion of contaminated food products. ''Listeria'' has been isolated from raw meat, dairy products, vegetables, and seafood. Soft cheeses and unpasteurized milk are potential dangers, however post-[[pasteurization]] outbreaks of infection from dairy have been from pasteurized milk.<ref name=Sherris/>


There are four distinct clinical syndromes:
==[[Listeriosis pathophysiology|Pathophysiology]]==
:*Infection in pregnancy: ''Listeria'' can proliferate asymptomatically in the vagina and uterus. If the mother becomes symptomatic, it is usually in the third trimester. Symptoms include [[fever]], [[myalgia]]s, [[arthralgias]] and [[headache]]. Abortion, stillbirth and preterm labor are complications of GU infection.
:*Neonatal infection (granulomatosis infantisepticum): There are two forms. One, an early-onset [[sepsis]], with ''Listeria'' acquired in utero, results in premature birth. ''Listeria'' can be isolated in the [[placenta]], [[blood]], [[meconium]], [[nose]], [[ear]]s, and [[throat]]. Another, late-onset meningitis is acquired through vaginal transmission, although it also has been reported with caesarean deliveries.
:*[[Central nervous system|CNS]] infection: ''Listeria'' has a predilection for the brain [[parenchyma]], especially the [[brain stem]], and the [[meninges]]. Mental status changes are common. Seizures occur in at least 25% of patients. Cranial nerve palsies, [[encephalitis]], [[meningitis]], [[meningoencephalitis]] and [[abscess]]es can all occur.
:*[[Gastroenteritis]]: ''L monocytogenes'' can produce food-borne diarrheal disease, which typically is noninvasive. The median incubation period is 1-2 days, with diarrhea lasting anywhere from 1-3 days. Patients present with fever, muscle aches, gastrointestinal nausea or diarrhea, headache, stiff neck, confusion, loss of balance, or convulsions.


==Diagnosis and treatment==
==[[Listeriosis epidemiology and demographics|Epidemiology & Demographics]]==
''L monocytogenes'' can often be cultured from the blood, and always cultured from the [[Cerebrospinal fluid|CSF]]. There are no reliable serological or stool tests.


[[Bacteremia]] should be treated for 2 weeks, [[meningitis]] for 3 weeks, and [[brain abscess]] for at least 6 weeks. [[Ampicillin]] generally is considered [[antibiotic]] of choice; [[gentamicin]] is added frequently for its synergistic effects. Overall mortality rate is 20-30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive.
==[[Listeriosis epidemiology and demographics|Risk Factors]]==


==Prevention==
==[[Listeriosis screening|Screening]]==
Cook all raw food thoroughly. Wash raw vegetables. Avoid consumption of raw milk or raw milk products. Wash hands, knives, and cutting boards after handling uncooked foods. For pregnant or immunocompromised patients, avoid soft cheeses (eg.: feta, Brie, Camembert cheese, bleu cheese; cream cheese, yoghurt, and cottage cheese are considered safe. Reheat leftover or ready-to-eat foods (eg.: hot dogs) until steaming hot. Avoid delicatessen foods unless they are thoroughly reheated.<ref name=CDC_Listeriosis>{{cite web | title=Listeriosis | work=CDC: Division of Bacterial and Mycotic Diseases | url=http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_g.htm#prevented | accessdate=2006-05-02}}</ref>


==See also==
==[[Listeriosis causes|Causes]]==
 
==[[Listeriosis differential diagnosis|Differentiating Listeriosis from other Diseases]]==
 
==[[Listeriosis natural history|Natural History, Complications & Prognosis]]==
 
==Diagnosis==
[[Listeriosis history and symptoms|History & Symptoms]] | [[Listeriosis physical examination|Physical Examination]] | [[Listeriosis staging|Staging]] | [[Listeriosis laboratory tests|Lab Tests]] | [[Listeriosis electrocardiogram|Electrocardiogram]] | [[Listeriosis chest x ray|Chest X Ray]] | [[Listeriosis CT|CT]] | [[Listeriosis MRI|MRI]] | [[Listeriosis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Listeriosis other imaging findings|Other Imaging Findings]] | [[Listeriosis other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
[[Listeriosis medical therapy|Medical Therapy]] | [[Listeriosis surgery|Surgery]] | [[Listeriosis primary prevention|Primary Prevention]] | [[Listeriosis secondary prevention|Secondary Prevention]]
 
==Related chapters==
*[[List of foodborne illness outbreaks]]
*[[List of foodborne illness outbreaks]]


==References==
==Resources==
<div class="references-small"><references/></div>
 
==External links==
*[http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_t.htm CDC Listeriosis site]
*[http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_t.htm CDC Listeriosis site]
*[http://www.cattle.com/articles/title/Listeriosis.aspx Listeriosis in Cattle]
*[http://www.cattle.com/articles/title/Listeriosis.aspx Listeriosis in Cattle]
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[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Disease]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Mature chapter]]
 
[[Category:Overview complete]]
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Revision as of 19:17, 8 February 2012

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