Listeriosis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
Following transmission, the majority of healthy patients do not develop clinical manifestations or may develop a mild, transient [[bacteremia]]. Early clinical manifestations (usually [[fever]]) typically develop early within 24 hours of transmission. If left untreated, patients typically progress within 1-90 days to develop ''[[Listeria monocytogenes|Listeria]]''-associated complications, including [[bacteremia]], [[abscess]] formation, [[pneumonia]], [[ARDS]], [[acute kidney injury]], and [[CNS]] impairment. Among healthy children and young adults, the prognosis of listeriosis is generally good. Prognosis is poorer among high-risk populations, who are more likely to develop complications and death even with prompt management.


==Natural History==
==Natural History==
The majority of cases of listeriosis are sporadic. ALthough the source is usually unknown, contaminated food is the most common vehicle of transmission. Some patients may be transitory carriers of the bacteria, without having the disease. Once the bacteria penetrate the gastrointestinal lining, it will travel through the blood to otherwise aseptic sites, such as the CNS, the uterus, and sometimes the heart, being responsible for diseases such as:
*Following transmission, the majority of healthy patients do not develop clinical manifestations or may develop a mild, transient [[bacteremia]].<ref name=Mandell>{{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
*The median [[incubation period]] for listeriosis-associated [[gastroenteritis]] is approximately 24 hours (range from 6 hours to 10 days).
* Infection in pregnancy
*Systemic manifestations of listeriosis may be slow-occurring, and the duration from transmission to development of systemic manifestations widely varies between 1 day to 90 days following transmission.<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>
* Sepsis of unknown origin
* Bacteremia
* CNS Infection
* Endocarditis
* Focal infections
 
The mean [[incubation period]] for [[febrile]] [[gastroenteritis]] following [[listeriosis]] is 24h, however, these may range from 6h up to 10 days. In the case of the remaining invasive diseases, the mean [[incubation period]] is 35 days, ranging from 1 up to 91 days.<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>


===Febrile Gastroenteritis===
===Febrile Gastroenteritis===
[[Febrile]][[gastroenteritis]] accounts for less than 1% of reported [[bacterial]] food-born [[infections]] occurring usually after [[ingestion]] of a large inoculum of [[bacteria]] from contaminated foods. Illness typically occurs 24 hours after [[ingestion]] of contaminated food, presenting with [[symptoms]] such as [[fever]], [[nausea]], [[vomiting]] and [[watery diarrhea]].
*''[[Listeria monocytogenes|Listeria]]''-associated [[gastroenteritis]] typically occurs 24 hours following [[ingestion]] of contaminated food.
 
*Patients typically manifest with [[fever]], [[nausea]], [[vomiting]], and [[watery diarrhea]].
It generally lasts for 2 days and the patient experiences complete recovery from the symptoms. Some patients may be asymptomatic for the disease, while others, [[immunocompromised]], pregnant women and elder patients, in rare cases, present with invasive [[infection]]. ''L. monocytogenes'' [[infection]] should be considered when outbreaks of foodborne [[gastroenteritis]] surge and stool cultures fail to identify the [[pathogen]]<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>.
*''[[Listeria monocytogenes|Listeria]]''-associated [[gastroenteritis]] is usually self-limited and lasts for a mean of 2 days among healthy individuals.
*In high-risk patients, systemic manifestations of ''[[Listeria monocytogenes|Listeria]]'' may occur, and patients are at higher risk of developing ''[[Listeria monocytogenes|Listeria]]''-associated complications.<ref name=Mandell>{{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>


===Infection in Pregnancy===
===Infection in Pregnancy===
[[Pregnant]] women have greater risk of contracting [[listeriosis]] since during [[pregnancy]] there is a slight impairment of [[cell-mediated immunity]]. ''Lysteria'' is also able to proliferate in the [[placenta]], in hard-to-reach areas for the [[immune system]]. [[Infection]] occurs more frequently during the third trimester of [[gestation]], with an estimated 17 fold increase<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>, presenting most commonly with flu-like symptoms, such as [[fever]] and [[chills]].
*Among [[pregnant]] women, listeriosis typically manifests during the third trimester of [[gestation]].<ref name=Mandell>{{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>  
 
*Pregnant women typically first present with mild [[flu]]-like [[symptoms]], such as [[fever]] and [[chills]], that are difficult to diagnose.
The [[infection]] may be mild and the diagnosis missed when [[blood cultures]] are not obtained. Since [[bacteremia]] with no [[CNS]] involvement is common rule in pregnant women with [[listeriosis]], [[blood cultures]] should always be obtained in [[pregnant]] women who present with [[fever]], with no other possible cause, such as [[UTI]] or [[pharyngitis]]. Because cell-to-cell [[transmission]] facilitates maternal-fetal [[transmission]]<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>, [[listeriosis]] in [[pregnant]] women, can result in [[fetal death]], [[premature birth]], or [[infected]] newborns.
*As the disease progresses, [[pregnant]] women typically develop ''[[Listeria monocytogenes|Listeria]]''-associated [[bacteremia]] (typically without [[CNS]] involvement)
 
*If left untreated, [[listeriosis]] among [[pregnant]] women typically results in [[fetal]] sequelae, including [[fetal death]], [[premature birth]], or [[neonatal sepsis]].<ref name=Mandell>{{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>
Among [[pregnant]] women with [[listeriosis]], 2/3 of the surviving infants develop clinical [[neonatal]] [[listeriosis]].<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>. The newborn also has great risk of developing [[granulomatosis]] infantiseptica, a severe ''[[in utero]]'' [[infection]] resulting from transplacental transmission,  in which infants may present with:
*disseminated [[abscesses]]
*[[granulomas]] in multiple internal organs ([[brain]], [[lungs]], [[liver]], [[spleen]] and [[kidneys]])
*papular or ulcerative skin lesions.
*most infants with this disease are stillborn or die soon after birth.
 
''[[L. monocytogenes]]'' is one of the three major causes of [[neonatal]] [[meningitis]], worldwide. The early diagnosis and treatment of pregnant women infected with ''Listeria'' may lead to the birth of a normal healthy child.<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>
 
===Sepsis of Unknown Origin===
Occurs in patients of all ages. [[Neonates]] usually tend to acquire the infection during or after [[birth]]. When this occurs during the first week of life, it usually manifests as [[sepsis]], while after this first week, it tends to have more variable manifestations, such as [[meningitis]].
 
Early onset of [[sepsis]] is associated with higher [[neonatal]] mortality. In this case, ''L. monocitogenes'' can be isolated from [[conjunctiva]]e, [[amniotic fluid]], [[meconium]], [[placental]] [[blood]], with higher concentrations of [[bacteria]] being found in the [[neonatal]] [[lung]] and [[gut]], which suggests that [[infection]] is acquired in [[uterus]], by inhalation of [[infected]] [[amniotic fluid]].<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>


===Bacteremia===
===Neonates===
*[[Neonates]] may be infected either in-utero [[infection]], which manifests with [[neonatal sepsis]] or during [[delivery]], which manifests with [[neonatal]] [[meningitis]].
*Both [[infections]] are usually rapid-occurring, and [[infected]] [[neonates]] appear sick-looking with greyish-bluish discoloration at birth.
*If left untreated, [[neonates]] may develop [[granulomatosis]] infantiseptica, a severe in-utero [[infection]], and death.<ref name=Mandell>{{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>


===CNS Infection===
===CNS Infection===
*''[[Listeria monocytogenes|L. monocytogenes]]'' has [[tropism]] for the [[brain stem]] and [[meninges]].
*Patients with ''[[Listeria monocytogenes|Listeria]]''-associated [[CNS]] [[infection]] typically develop [[fever]] followed by [[altered mental status]], [[seizures]], [[cranial nerve palsy]], [[hemiplegia]], and [[ataxia]].<ref name=Mandell>{{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>
*Patients may either develop rhombencephalitis, [[cerebritis]], [[spinal cord]] [[infection]], [[meningitis]] alone, [[encephalitis]] alone, or both ([[meningoencephalitis]]).
*Patients with ''[[Listeria monocytogenes|Listeria]]''-associated rhombencephalitis typically experience a bi-phasic course. First, patients develop worsening [[headache]], [[fever]], [[vomiting]] for a 3-5 days, followed by an abrupt-onset of [[Neurological disorders|neurological impairment]] ([[cranial nerve palsy]], [[ataxia]], [[altered mental status]], [[seizures]]).<ref name=Mandell>{{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>
*If left untreated, [[brain abscesses]] may develop. The location of the [[brain abscesses]] is typically in the [[thalamus]], [[pons]], and/or [[medulla]].
*The majority of patients with advanced [[CNS disease]] develop long-term sequelae.


===Endocarditis===
===Endocarditis===
 
Listerial [[endocarditis]] may affect either [[native valve endocarditis|native]] or [[prosthetic valve]]s.
===Focal Infections===
*If left untreated, the majority of patients with ''[[Listeria monocytogenes|Listeria]]''-associated [[endocarditis]] progress to develop [[bacteremia]].<ref name=Mandell>{{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>


==Complications==
==Complications==
Invasive disease might complicate into:<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><ref name=WHO>{{cite web | title = Listeriosis | url = http://www.who.int/ith/diseases/listeriosis/en/ }}</ref>
*Compared with the general population, high-risk patients are more likely to develop invasive [[disease]] and ''[[Listeria monocytogenes|Listeria]]''-associated complications.<ref name="Lorber-1997">{{Cite journal  | last1 = Lorber | first1 = B. | title = Listeriosis. | journal = Clin Infect Dis | volume = 24 | issue = 1 | pages = 1-9; quiz 10-1 | month = Jan | year = 1997 | doi =  | PMID = 8994747 }}</ref>
*Complications of invasive disease include the following:<ref name=Mandell>{{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><ref name=WHO>{{cite web | title = Listeriosis | url = http://www.who.int/ith/diseases/listeriosis/en/ }}</ref>
* [[Disseminated intravascular coagulation]]
* [[Disseminated intravascular coagulation]]
* [[ARDS]]
* [[ARDS]]
* [[Rhabdomyolysis]]
* [[Rhabdomyolysis]]
* [[Acute Renal Failure]]
* [[Acute kidney injury]]
* [[Septicemia]]<ref name=Gray_1966>Gray, M. L., and A. H. Killinger. 1966. Listeria monocytogenes and listeric infection. Bacteriol. Rev. 30:309-382.</ref>, [[meningitis]] (or [[meningoencephalitis]])<ref name=Gray_1966/>
* [[Septicemia]]<ref name=Gray_1966>Gray, M. L., and A. H. Killinger. 1966. Listeria monocytogenes and listeric infection. Bacteriol. Rev. 30:309-382.</ref>
* [[Meningitis]]<ref name=Gray_1966/>
* [[Encephalitis]]<ref name=Armstrong1993>Armstrong, R. W., and P. C. Fung. 1993. Brainstem encephalitis (Rhombencephalitis) due to Listeria monocytogenes:  case report and review. Clin. Infect. Dis. 16:689-702.</ref>
* [[Encephalitis]]<ref name=Armstrong1993>Armstrong, R. W., and P. C. Fung. 1993. Brainstem encephalitis (Rhombencephalitis) due to Listeria monocytogenes:  case report and review. Clin. Infect. Dis. 16:689-702.</ref>
* [[Corneal ulcer]]<ref name=Holland_1987>Holland, S., E. Alfonso, H. Gelender, D. Heidemann, A. Mendelsohn, S. Ullman, and D. Miller. 1987. Corneal ulcer due to Listeria monocytogenes. Cornea 6:144-146.</ref>
* [[Corneal ulcer]]<ref name=Holland_1987>Holland, S., E. Alfonso, H. Gelender, D. Heidemann, A. Mendelsohn, S. Ullman, and D. Miller. 1987. Corneal ulcer due to Listeria monocytogenes. Cornea 6:144-146.</ref>
* [[Pneumonia]]<ref name=whitelock_1989>Whitelock-Jones, L., J. Carswell, and K. C. Rassmussen. 1989. Listeria pneumonia. A case report. South African Medical Journal 75:188-189.</ref>
* [[Pneumonia]]<ref name=whitelock_1989>Whitelock-Jones, L., J. Carswell, and K. C. Rassmussen. 1989. Listeria pneumonia. A case report. South African Medical Journal 75:188-189.</ref>
* [[uterus|Intrauterine]] or [[cervix|cervical]] infection in pregnant women, may result in:
* [[uterus|Intrauterine]] or [[cervix|cervical]] [[infection]] in pregnant women, may result in:<ref name="pmid25241232">{{cite journal |vauthors=Maertens de Noordhout C, Devleesschauwer B, Angulo FJ, Verbeke G, Haagsma J, Kirk M, Havelaar A, Speybroeck N |title=The global burden of listeriosis: a systematic review and meta-analysis |journal=Lancet Infect Dis |volume=14 |issue=11 |pages=1073–82 |year=2014 |pmid=25241232 |pmc=4369580 |doi=10.1016/S1473-3099(14)70870-9 |url=}}</ref>
:* [[miscarriage|Spontaneous abortion]] (2nd/3rd trimester)
:* [[miscarriage|Spontaneous abortion]] (2nd/3rd trimester)
:* [[Stillbirth]]
:* [[Stillbirth]]
:* Surviving neonates of Fetomaternal [[Listeriosis]] may suffer from:
:* [[Preterm birth]]
::* [[Granulomatosis]] infantiseptica - [[pyogenic]] [[granulomas]] distributed over the whole body, and may suffer from physical retardation
:* [[Granulomatosis]] infantiseptica: [[pyogenic]] [[granulomas]] distributed over the whole body, and the newborn may suffer from physical retardation
::* [[Influenza]]-like [[symptoms]], including persistent [[fever]] usually precede the onset of the aforementioned disorders.
*Reinfection (rare)


==Prognosis==
==Prognosis==
The [[prognosis]] of [[Listeriosis]] depends on the health status of the host:<ref name=CDC>{{cite web | title = Listeria | url = http://www.cdc.gov/listeria/definition.html }}</ref>
The [[prognosis]] of [[listeriosis]] depends on the health status of the host:<ref name=CDC>{{cite web | title = Listeria | url = http://www.cdc.gov/listeria/definition.html }}</ref>
* Healthy older children and adults have a lower [[death rate]].
* Healthy children and young adults have a good prognosis and are at low-risk of developing ''[[Listeria monocytogenes|Listeria]]''-associated complications and long-term sequelae.
* [[Listeriosis]] in a [[fetus]] or infant results in a poor [[outcome]] with a high [[death]] rate.
* High-risk populations, including [[pregnant]] women, [[neonates]], elderly, and [[immunosuppressed]] individuals, have a poorer prognosis with a high death rate (even when treatment is administered promptly).
* Even with prompt treatment, some [[listeriosis]] cases result in death. This is particularly likely in older adults and in persons with other medical conditions.


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Bacterial diseases]]
[[Category:Disease]]
[[Category:Infectious disease]]


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Latest revision as of 15:56, 5 April 2017

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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

Following transmission, the majority of healthy patients do not develop clinical manifestations or may develop a mild, transient bacteremia. Early clinical manifestations (usually fever) typically develop early within 24 hours of transmission. If left untreated, patients typically progress within 1-90 days to develop Listeria-associated complications, including bacteremia, abscess formation, pneumonia, ARDS, acute kidney injury, and CNS impairment. Among healthy children and young adults, the prognosis of listeriosis is generally good. Prognosis is poorer among high-risk populations, who are more likely to develop complications and death even with prompt management.

Natural History

  • Following transmission, the majority of healthy patients do not develop clinical manifestations or may develop a mild, transient bacteremia.[1]
  • The median incubation period for listeriosis-associated gastroenteritis is approximately 24 hours (range from 6 hours to 10 days).
  • Systemic manifestations of listeriosis may be slow-occurring, and the duration from transmission to development of systemic manifestations widely varies between 1 day to 90 days following transmission.[2][3][4]

Febrile Gastroenteritis

Infection in Pregnancy

Neonates

CNS Infection

Endocarditis

Listerial endocarditis may affect either native or prosthetic valves.

Complications

Prognosis

The prognosis of listeriosis depends on the health status of the host:[12]

  • Healthy children and young adults have a good prognosis and are at low-risk of developing Listeria-associated complications and long-term sequelae.
  • High-risk populations, including pregnant women, neonates, elderly, and immunosuppressed individuals, have a poorer prognosis with a high death rate (even when treatment is administered promptly).

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 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.
  2. ↑ Ooi ST, Lorber B (2005). "Gastroenteritis due to Listeria monocytogenes". Clin Infect Dis. 40 (9): 1327–32. doi:10.1086/429324. PMID 15825036.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ Lorber, B. (1997). "Listeriosis". Clin Infect Dis. 24 (1): 1–9, quiz 10-1. PMID 8994747. Unknown parameter |month= ignored (help)
  6. ↑ "Listeriosis".
  7. ↑ 7.0 7.1 Gray, M. L., and A. H. Killinger. 1966. Listeria monocytogenes and listeric infection. Bacteriol. Rev. 30:309-382.
  8. ↑ Armstrong, R. W., and P. C. Fung. 1993. Brainstem encephalitis (Rhombencephalitis) due to Listeria monocytogenes: case report and review. Clin. Infect. Dis. 16:689-702.
  9. ↑ Holland, S., E. Alfonso, H. Gelender, D. Heidemann, A. Mendelsohn, S. Ullman, and D. Miller. 1987. Corneal ulcer due to Listeria monocytogenes. Cornea 6:144-146.
  10. ↑ Whitelock-Jones, L., J. Carswell, and K. C. Rassmussen. 1989. Listeria pneumonia. A case report. South African Medical Journal 75:188-189.
  11. ↑ Maertens de Noordhout C, Devleesschauwer B, Angulo FJ, Verbeke G, Haagsma J, Kirk M, Havelaar A, Speybroeck N (2014). "The global burden of listeriosis: a systematic review and meta-analysis". Lancet Infect Dis. 14 (11): 1073–82. doi:10.1016/S1473-3099(14)70870-9. PMC 4369580. PMID 25241232.
  12. ↑ "Listeria".


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