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| ==Overview== | | ==Overview== |
| For symptomatic patients, diagnosis is confirmed only after isolation of Listeria monocytogenes from a normally sterile site, such as blood, spinal fluid (in the setting of nervous system involvement), or amniotic fluid/placenta (in the setting of pregnancy). Importantly, a negative culture does not rule out infection in the presence of strong clinical suspicion. Serological tests are unreliable, and not recommended at the present time. Some additional serological and laboratory findings are associated with Listeriosis. [[MRI]] images may be used for the [[diagnosis]] of [[CNS]] infections
| | Additional studies for the diagnosis of listeriosis are not recommended. |
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| ==Other Laboratory Studies== | | ==Other Laboratory Studies== |
| ===CSF Analysis===
| | Additional studies for the diagnosis of listeriosis are not recommended. |
| [[CSF]] analysis may lead to the confirmation of [[listeriosis]]. Common findings include:
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| * [[Pleocytosis]]
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| * More than 25 [[lymphocytes]] in [[CSF]] [[Differential blood count (patient information)|differential count]], without [[antibiotic]] therapy
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| * Moderately elevated [[CSF]] [[protein]] concentration with reduced [[CSF]] [[glucose]] concentration<ref name="pmid9772921">{{cite journal| author=Mylonakis E, Hohmann EL, Calderwood SB| title=Central nervous system infection with Listeria monocytogenes. 33 years' experience at a general hospital and review of 776 episodes from the literature. | journal=Medicine (Baltimore) | year= 1998 | volume= 77 | issue= 5 | pages= 313-36 | pmid=9772921 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9772921 }} </ref>
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| * Despite the name "monocytogenes", more that half the patients have increased levels of [[neutrophils]] in [[CSF]].
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| * [[Gram stain]] of the [[CSF]] has very low [[sensitivity]] and even when organisms are seen, they may be misidentified. <ref name="pmid4998254">{{cite journal| author=Lavetter A, Leedom JM, Mathies AW, Ivler D, Wehrle PF| title=Meningitis due to Listeria monocytogenes. A review of 25 cases. | journal=N Engl J Med | year= 1971 | volume= 285 | issue= 11 | pages= 598-603 | pmid=4998254 | doi=10.1056/NEJM197109092851103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4998254 }} </ref> Therefore, ''Listeria monocytogenes'' should always be considered when similar organisms are growing in [[blood culture |blood]] or [[CSF]] cultures. The presumptive diagnosis of [[viral meningitis]] should also be carefully considered in [[immunocompromised]], chronically ill, or elderly patients, presenting with acute [[meningitis]] and a negative [[Gram stain]]. In rhombencephalitis patients diagnosis is often delayed because [[CSF]] examination reveals only mild abnormalities.
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| * A [[polymerase chain reaction]] assay has been developed for the ''hly gene'' detection, which encodes for the ''listeriolysin O'', in [[CSF]] cultures. However, despite a high [[specificity]] and more [[sensitivity]], it is not commercially available yet.
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| ===Serodiagnosis===
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| [[Diagnosis]] of [[listeriosis]] with [[antibodies]] for ''[[listeriolysin O]]'' can be useful among [[infected]] patients with noninvasive disease.<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>
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
| [[Category:Bacterial diseases]]
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| [[Category:Disease]]
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| [[Category:Infectious disease]]
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| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |
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| | [[Category:Emergency mdicine]] |
| | [[Category:Disease]] |
| | [[Category:Up-To-Date]] |
| | [[Category:Infectious disease]] |
| | [[Category:Neurology]] |
| | [[Category:Gastroenterology]] |