II. Pathophysiology

  1. Non-spore forming Gram Positive Rod (Diphtheroid similar to Corynebacterium)
  2. Facultative Anaerobe, and able to grow at cold Temperatures (4 to 10 C)
  3. Flagella which result in a tumbling-type of motility
  4. Listeriolysin O is a virulence factor produced by Listeria
    1. Activated in the acidic environment of Phagosomes (e.g. Macrophages)
    2. Results in cytolysis of Macrophages, resulting in release of Listeria monocytogenes
  5. Listeriolysin O allows for Listeria to survive within immune cells as a facultative intracellular organism
    1. Immunocompetent patients can destroy intracellular Listeria
    2. However, Immunocompromised patients are enable to fully eradicate intracellular Listeria
  6. References
    1. Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 59-61

III. Causes: Sources

  1. See Foodbourne Illness
  2. Deli Meat
  3. Frozen Vegetables (2016 outbreak in U.S.)
  4. Unpasteurized milk (including derived soft cheese, cole slaw, butter)
    1. (2008) MMWR Morb Mortal Wkly Rep 57(40):1097-100 +PMID:18846031 [PubMed]

IV. Risk Factors: Severe, invasive disease

  1. Elderly or Immunocompromised patients (e.g. Lymphoma, Corticosteroids, organ transplant, AIDS)
    1. Listeria is among the most common Meningitis causes in this cohort
  2. Pregnancy
    1. Typically, affects women in the third trimester, resulting in bacteremia and Sepsis
    2. Affects the fetus in nearly one quarter of cases resulting in neonatal death or premature birth
  3. Newborns
    1. Infection may be acquired via Vaginal Delivery in asymptomatic, colononized mothers
    2. Results in Neonatal Sepsis and Meningitis, most commonly presenting at 2 weeks of life

V. Symptoms

  1. Onset
    1. Gastrointestinal symptoms start within 9 to 48 hours
    2. Immunocompetent hosts typically have self-limited course
    3. Invasive disease onset delayed for 2 to 6 weeks
  2. Gastrointestinal infection
    1. Fever
    2. Diarrhea
    3. Nausea
    4. Myalgias
  3. Invasive infection (esp. Immunocompromised patients)
    1. Bacteremia
    2. Meningitis
    3. Endocarditis
  4. Pregnancy (presents with flu-like illness)
    1. Premature delivery
    2. Stillbirth

VI. Labs

  1. Missed on Stool Culture

VII. Management

  1. See Acute Diarrhea
  2. Antibiotics
    1. Not typically used (self-limited disease in normal hosts)
    2. Consider in severe, invasive cases or high risk patients (5 days Amoxicillin or Septra has been used)

VIII. Resources

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Related Studies

Ontology: Listeriosis (C0023860)

Definition (MEDLINEPLUS)

Listeriosis is a foodborne illness caused by Listeria monocytogenes, bacteria found in soil and water. It can be in a variety of raw foods as well as in processed foods and foods made from unpasteurized milk. Listeria is unlike many other germs because it can grow even in the cold temperature of the refrigerator.

Symptoms include fever and chills, headache, upset stomach and vomiting. Treatment is with antibiotics.

Anyone can get the illness. But it is most likely to affect pregnant women and unborn babies, older adults, and people with weak immune systems. To reduce your risk

  • Use precooked and ready-to-eat foods as soon as you can
  • Avoid raw milk and raw milk products
  • Heat ready-to-eat foods and leftovers until they are steaming hot
  • Wash fresh fruits and vegetables
  • Avoid rare meat and refrigerated smoked seafood

Centers for Disease Control and Prevention

Definition (NCI) A bacterial infection caused by Listeria monocytogenes. It occurs in newborns, elderly, and immunocompromised patients. The bacteria are transmitted through ingestion of contaminated food. Clinical manifestations include fever, muscle pain, respiratory distress, nausea, diarrhea, neck stiffness, irritability, seizures, and lethargy.
Definition (MSH) Infections with bacteria of the genus LISTERIA.
Definition (CSP) gram positive bacterial infection with the genus Listeria including Listeria meningitis which causes clinical manifestations including fever, altered mentation, headache, meningeal signs, focal neurologic signs, and seizures.
Concepts Disease or Syndrome (T047)
MSH D008088
ICD9 027.0
ICD10 A32 , A32.9
SnomedCT 187320005, 186320001, 186315001, 406591006, 4241002
LNC LA10485-3
English Infection, Listeria, Infections, Listeria, Listeriosis NOS, Listeriosis, unspecified, [X]Listeriosis, unspecified, LISTERIA INFECT, INFECT LISTERIA, listeriosis listeria monocytogenes, listeriosis, listeriosis (diagnosis), Listeria monocytogenes infection (diagnosis), Listeria infections, Listeria monocytogenes infection, Listeria Infection, Listeria Infections, Listerioses, listeria monocytogenes infection, listeria infection, Listeriosis [Disease/Finding], [X]Listeriosis, unspecified (disorder), Listeriosis NOS (disorder), Infection due to Listeria monocytogenes (disorder), Listeria infection, Circling disease, Infection due to Listeria monocytogenes, Listerellosis, Listeriosis (disorder), Listeria monocytogenes; infection, infection; Listeria monocytogenes, Listeriosis, NOS, Listeriosis, Infection by Listeria monocytogenes
Italian Infezioni da Listeria, Infezione da Listeria, Infezione da Listeria monocytogenes, Listeriosi
Dutch Listeria monocytogenes-infectie, Listeria monocytogenes; infectie, infectie; Listeria monocytogenes, Listeriose, niet gespecificeerd, listeriosis, Infectie, listeria-, Infecties, listeria-, Listeria-infectie, Listeria-infecties, Listeriose
French Infection à Listeria monocytogenes, Infection à Listeria, Listérelloses, Listériose, Infections à Listéria, Infections à Listeria, Listérioses
German Listeria Infektion, Listeria monocytogenes Infektion, Listeriose, nicht naeher bezeichnet, Listeria-Infektionen, Listerieninfektionen, Listeriose
Portuguese Infecção por listeria, Infecção por Listeria monocytogenes, Infecções a listeria, Listeriose
Spanish Infección por listeria, Infección por Listeria monocytogenes, listeriosis, SAI (trastorno), listeriosis, SAI, [X]listeriosis, no especificada (trastorno), infección por Listeria monocytogenes (trastorno), [X]listeriosis, no especificada, enfermedad de los círculos, infección por Listeria monocytogenes, listerelosis, listeriosis (trastorno), listeriosis, Infecciones por listeria, Listeriosis
Japanese リステリア感染, リステリア菌感染, リステリアショウ, リステリアカンセン, リステリアキンカンセン, リステリア感染症, リステリア症
Swedish Listeriainfektioner
Czech Listeria - infekce, Listeriové infekce, Listerióza, Listeriová infekce, Infekce Listeria monocytogenes, listerióza, listeriosis
Finnish Listerioosit
Russian LISTERIOZNYE INFEKTSII, ЛИСТЕРЕЛЛЕЗ, ЛИСТЕРИОЗНЫЕ ИНФЕКЦИИ, НЕВРЕЛЛЕЗ, LISTERIOZ, LISTERELLEZ, NEVRELLEZ, ЛИСТЕРИОЗ
Korean 리스테리아증, 상세불명의 리스테리아증
Croatian LISTERIJE, INFEKCIJE
Polish Zakażenie Listeria, Listerioza
Hungarian listeriosis, Listeria fertőzések, Listeria monocytogenes fertőzés, Listeria fertőzés
Norwegian Listeriose, Listeriainfeksjoner

Ontology: Listeria monocytogenes (C0023861)

Definition (NCI) A species of facultatively anaerobic, Gram positive, rod shaped bacteria in the phylum Firmicutes. This species is motile by up to four peritrichous flagella, catalase positive, hemolytic, produces acid from glucose, trehalose, levulose and salacin, indole negative and does not reduce nitrate. L. monocytogenes is a food borne pathogen, being the causative agent of listeriosis in humans and animals.
Definition (NCI_CDISC) Any bacterial organism that can be assigned to the species Listeria monocytogenes.
Definition (MSH) A species of gram-positive, rod-shaped bacteria widely distributed in nature. It has been isolated from sewage, soil, silage, and from feces of healthy animals and man. Infection with this bacterium leads to encephalitis, meningitis, endocarditis, and abortion.
Concepts Bacterium (T007)
MSH D008089
SnomedCT 36094007
LNC LP16653-5
Swedish Listeria monocytogenes
Czech Listeria monocytogenes
Finnish Listeria monocytogenes
Russian LISTERIOZA BAKTERII, LISTERIA MONOCYTOGENES, ЛИСТЕРИОЗА БАКТЕРИИ
English Listeria monocytogenes (Murray et al. 1926) Pirie 1940, listeria monocytogene, monocytogenes listeria, listeria monocytogenes, Bacterium monocytogenes, Bacterium monocytogenes hominis, Corynebacterium infantisepticum, Corynebacterium parvulum, Erysipelothrix monocytogenes, Listerella hepatolytica, LISTERIA MONOCYTOGENES, Listeria monocytogenes (organism), Listeria monocytogenes
Croatian LISTERIA MONOCYTOGENES
Polish Listeria monocytogenes, Pałeczki listeriozy
Norwegian Listeria monocytogenes
Spanish Listeria monocytogenes (organismo), Listeria monocytogenes
French Listeria monocytogenes
German Corynebacterium infantisepticum, Listeria monocytogenes
Italian Listeria monocytogenes
Dutch Listeria monocytogenes
Portuguese Listeria monocytogenes