Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • headache
  • altered mental status

Other diagnostic factors

  • fever
  • diarrhoea and abdominal pain
  • generalised malaise
  • flu-like symptoms in pregnancy
  • poor feeding (neonates)
  • meningismus
  • cranial nerve deficits
  • cerebellar signs
  • focal neurological signs
  • seizures
  • hypotension
  • intra-partum fever
  • bleeding diathesis with haemorrhage
  • cardiac murmur

Risk factors

  • exposure to contaminated food
  • age >45-50 years
  • pregnancy
  • neonates
  • immunocompromised states
  • impaired stomach acidification

Diagnostic investigations

1st investigations to order

  • FBC
  • urine pregnancy test
  • blood cultures
  • brain MRI
  • brain CT
  • CSF analysis
Full details

Investigations to consider

  • PT and PTT
  • D-dimer
  • placenta and amniotic fluid culture
  • cervical swab culture
  • meconium Gram stain and culture
  • Listeria serology
  • food analysis
  • stool culture
  • other stool analyses
  • EEG
  • echocardiography
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Honorary Clinical Senior Lecturer

Glasgow University

Consultant in Acute and General Medicine

Monklands Hospital

NHS Lanarkshire

Scotland

Disclosures

PMK declares that he has no competing interests.

Professor

Infectious Diseases Division

Massachusetts General Hospital and Harvard Medical School

Boston

MA

Disclosures

EM is an author of several references cited in this monograph. He has also received grant support from T2 Biosystems, Astellas pharma, and Boehringer Ingelheim. He is also a member of Astellas pharma.

Peer reviewers VIEW ALL

Professor of Medicine and Community Health

Brown University

Providence

RI

Disclosures

JDR declares that he has no competing interests.

Professor

Infection and Immunity

Consultant Microbiologist

Bacteriology Dept

Southern General Hospital

Glasgow

UK

Disclosures

AL declares that he has no competing interests.

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