Thread by @MayoClinicINFD

Weekend Digest

Name the Pathogen

Five Clues
1. Gram-positive bacillus with tumbling motility
2. Food safety
3. Age, pregnancy and steroids
4. Rhombencephalitis
5. Ampicillin+Gentamicin

2/
#Listeria monocytogenes

Soil
Decaying plant matter

Processed/unprocessed food (deli meats, hotdog, soft cheese, pate, fruits, greens/salads)

Oral route —> intestinal mucosa penetration —> systemic infection

3/
#Listeria monocytogenes and food safety!

Listeria survives in refrigeration temperature

Sporadic isolated cases
Occasional outbreaks due to food contamination (see link for recent outbreak)

fda.gov/food/outbreaks…

4/
#Listeria monocytogenes

High-risk patient groups:
- pregnant women
- newborns and older adults
- people with suppressed immune systems (e.g., use of steroids

5/
#Listeria monocytogenes

#Listeriosis clinical syndromes
1. Febrile gastroenteritis
2. Bacteremia
3. CNS infection (meningitis, meningoencephalitis, rhombencephalitis)

6/
#Listeriosis clinical syndromes in pregnancy

Most common in 3rd trimester

Listeria in blood can cross placenta —> fetal death, premature birth, infected newborn

Granulomatosis infantiseptica - granulomas / abscesses in various internal organs

eurosurveillance.org/content/10.280…

7/
#Listeriosis Rx

PCN / amoxicillin / ampicillin

#Gentamicin for synergy to ampicillin in Rx CNS infections

BUT
Detrimental effect of steroids - increase mortality with CNS listeriosis #MonaLisa

pubmed.ncbi.nlm.nih.gov/28139432/

/8
#Listeria #ClinicalPearls
1. Food: #deli meats
2. Risk: #pregnant, #ICH, young/old
3. Febrile #gastroenteritis, bacteremia, #meningoencephalitis
4. Rx: #ampicillin +/- gentamicin
5. Do not use steroids in listeria meningitis (increase mortality)

Thank you for participating!