Listeriosis history and symptoms: Difference between revisions
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==Overview== | ==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== | ==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== | ||
Although some patients may be transitory carriers of [[listeriosis]], others become [[symptomatic]]. | 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=== | ===Febrile Gastroenteritis=== | ||
* [[Fever]] | * [[Fever]] | ||
| Line 18: | Line 16: | ||
* [[Nausea]] | * [[Nausea]] | ||
* [[Vomiting]] | * [[Vomiting]] | ||
* [[Abdominal pain]] | |||
* [[Headache]] | * [[Headache]] | ||
* [[Sore throat]] | |||
* [[Arthralgia|Joint]] and [[myalgia|muscle pain]] | * [[Arthralgia|Joint]] and [[myalgia|muscle pain]] | ||
| Line 28: | Line 28: | ||
===Sepsis of Unknown Origin=== | ===Sepsis of Unknown Origin=== | ||
* [[Fever]] | * [[Fever]] | ||
* [[Chills]] | * [[Chills]] | ||
* [[Malaise]] | * [[Malaise]] | ||
| Line 41: | Line 39: | ||
===CNS Infection=== | ===CNS Infection=== | ||
====Meningoencephalitis==== | ====Meningoencephalitis==== | ||
The clinical presentation can range from mild [[fever]] and mental status changes, to a more aggressive course with [[coma]]. | 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 | *[[Cranial nerve]] abnormalities, most commonly [[Sixth nerve palsy|6th]] and [[Facial palsy|7th cranial nerve palsies]] | ||
*[[ | *Abnormal [[gait]] ([[ataxia]]) | ||
*[[Tremors]] | *[[Tremors]] | ||
*[[ | *[[Weakness]] of one side of the body ([[hemiplegia]]) | ||
*[[Deafness]] | *[[Deafness]] | ||
*[[ | *Abnormal movements ([[seizures]]) | ||
====Cerebritis/ Encephalitis==== | ====Cerebritis/ Encephalitis==== | ||
In | 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]] | *[[Fever]] | ||
*[[Headache]] | *[[Headache]] | ||
| Line 56: | Line 54: | ||
====Rhombencephalitis==== | ====Rhombencephalitis==== | ||
Rhombencephalitis often follows a biphasic course | Rhombencephalitis often follows a biphasic course. The initial phase lasts for about 4 days and is characterized by the following symptoms: | ||
*[[Headache]] | *[[Headache]] | ||
*[[Fever]] | *[[Fever]] | ||
| Line 62: | Line 60: | ||
*[[Vomiting]] | *[[Vomiting]] | ||
The initial phase is followed by an abrupt onset of: | |||
*Asymetrical [[cranial nerve]] palsies | *Asymetrical [[cranial nerve]] palsies | ||
*[[Ataxia]] | *[[Ataxia]] | ||
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{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
[[Category: | {{WS}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Neurology]] | |||
[[Category:Gastroenterology]] | |||
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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]
- Cranial nerve abnormalities, most commonly 6th and 7th cranial nerve palsies
- Abnormal gait (ataxia)
- Tremors
- Weakness of one side of the body (hemiplegia)
- Deafness
- Abnormal movements (seizures)
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:
- Asymetrical cranial nerve palsies
- Ataxia
- Tremor
- Decreased consciousness
- Seizures
- Hemiparesis and/or hemisensory deficits
- Respiratory failure
References
- ↑ Ooi ST, Lorber B (2005). "Gastroenteritis due to Listeria monocytogenes". Clin Infect Dis. 40 (9): 1327–32. doi:10.1086/429324. PMID 15825036.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Southwick FS, Purich DL (1996). "Intracellular pathogenesis of listeriosis". N. Engl. J. Med. 334 (12): 770–6. doi:10.1056/NEJM199603213341206. PMID 8592552.
- ↑ 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.