Listeriosis other diagnostic studies: Difference between revisions
Rim Halaby (talk | contribs) |
Rim Halaby (talk | contribs) |
||
Line 7: | Line 7: | ||
==Other Laboratory Studies== | ==Other Laboratory Studies== | ||
===CSF | ===CSF Analysis=== | ||
[[CSF]] analysis may lead to the confirmation of [[listeriosis]]. Common findings include: | [[CSF]] analysis may lead to the confirmation of [[listeriosis]]. Common findings include: | ||
* [[Pleocytosis]] | * [[Pleocytosis]] | ||
Line 15: | Line 15: | ||
* [[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. | * [[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. | ||
* 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. | * 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. | ||
===Serodiagnosis=== | ===Serodiagnosis=== | ||
[[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> | [[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> | ||
==References== | ==References== |
Revision as of 15:23, 6 April 2015
Listeriosis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Listeriosis other diagnostic studies On the Web |
American Roentgen Ray Society Images of Listeriosis other diagnostic studies |
Risk calculators and risk factors for Listeriosis other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
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
Other Laboratory Studies
CSF Analysis
CSF analysis may lead to the confirmation of listeriosis. Common findings include:
- Pleocytosis
- More than 25 lymphocytes in CSF differential count, without antibiotic therapy
- Moderately elevated CSF protein concentration with reduced CSF glucose concentration[1]
- Despite the name "monocytogenes", more that half the patients have increased levels of neutrophils in CSF.
- Gram stain of the CSF has very low sensitivity and even when organisms are seen, they may be misidentified. [2] Therefore, Listeria monocytogenes should always be considered when similar organisms are growing in 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.
- 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.
Serodiagnosis
Diagnosis of listeriosis with antibodies for listeriolysin O can be useful among infected patients with noninvasive disease.[3]
References
- ↑ Mylonakis E, Hohmann EL, Calderwood SB (1998). "Central nervous system infection with Listeria monocytogenes. 33 years' experience at a general hospital and review of 776 episodes from the literature". Medicine (Baltimore). 77 (5): 313–36. PMID 9772921.
- ↑ Lavetter A, Leedom JM, Mathies AW, Ivler D, Wehrle PF (1971). "Meningitis due to Listeria monocytogenes. A review of 25 cases". N Engl J Med. 285 (11): 598–603. doi:10.1056/NEJM197109092851103. PMID 4998254.
- ↑ 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.