Summary
Definition
History and exam
Key diagnostic factors
- fever
- diarrhea and abdominal pain
- flu-like symptoms in pregnancy
Other diagnostic factors
- headache
- altered mental status
- meningismus
- cranial nerve deficits
- cerebellar signs
- focal neurologic signs
- seizures
- hypotension
- generalized malaise
- intrapartum fever
- poor feeding (neonates)
- bleeding diathesis with hemorrhage
- cardiac murmur
Risk factors
- exposure to contaminated food
- age >45-50 years
- pregnancy
- neonates
- immunocompromised states
- impaired stomach acidification
Diagnostic tests
1st tests to order
- CBC
- urine pregnancy test
- blood cultures
- brain MRI
- brain CT
- cerebrospinal fluid (CSF) analysis
Tests to consider
- prothrombin time (PT) and PTT
- D-dimer
- placenta and amniotic fluid culture
- cervical swab culture
- meconium Gram stain and culture
- Listeria serology
- food analysis
- stool culture
- polymerase chain reaction of blood
- other stool analyses
- electroencephalogram
- echocardiography
Treatment algorithm
gastroenteritis
systemic infection (excluding meningitis/meningoencephalitis)
meningitis/meningoencephalitis
Contributors
Authors
Petros M. Karsaliakos, MD, FRCP, MSc
Honorary Clinical Senior Lecturer
Glasgow University
Consultant in General Medicine
Queen Elizabeth University Hospital
NHS GGC
Scotland
Disclosures
PMK declares that he has no competing interests.
Eleftherios Mylonakis, MD, PhD, FIDSA, FAAM
Charles C.J. Carpenter Professor of Infectious Disease
Chair, Department of Medicine
Charles and Anne Duncan Presidential Distinguished Chair
Professor of Medicine, Weill Cornell Medical College & Houston Methodist Academic Institute
Adjunct Professor of Medicine, Warren Alpert Medical School of Brown University
Adjunct Clinical Professor, Texas A&M College of Medicine
Houston Methodist Hospital
Houston, TX
Disclosures
EM is an author of several references cited in this topic.
Peer reviewers
Josiah D. Rich, MD, MPH
Professor of Medicine and Community Health
Brown University
Providence
RI
Disclosures
JDR declares that he has no competing interests.
Alistair Leonord, MBChB, BSc, MRCPath, MD, DTM&H
Professor
Infection and Immunity
Consultant Microbiologist
Bacteriology Dept
Southern General Hospital
Glasgow
UK
Disclosures
AL declares that he has no competing interests.
References
Key articles
Mylonakis E, Hofmann EL, Calderwood SB. Central nervous system infection with Listeria monocytogenes. 33 years' experience at a general hospital and review of 776 episodes from the literature. Medicine (Baltimore). 1998 Sep;77(5):313-36. Abstract
Quereda JJ, Morón-García A, Palacios-Gorba C, et al. Pathogenicity and virulence of listeria monocytogenes: a trip from environmental to medical microbiology. Virulence. 2021 Dec;12(1):2509-45.Full text Abstract
Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. Committee opinion no. 614: management of pregnant women with presumptive exposure to listeria monocytogenes. Obstet Gynecol. 2014 Dec;124(6):1241-4. Abstract
Centers for Disease Control and Prevention. Listeria infection (listeriosis): clinical overview of listeriosis Aug 2024 [internet publication].Full text
Osek J, Lachtara B, Wieczorek K. Listeria monocytogenes - how this pathogen survives in food-production environments? Front Microbiol. 2022;13:866462.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Other bacterial meningitides
- Other brain abscesses
- Viral gastroenteritis
More DifferentialsGuidelines
- Listeria (Listeriosis)
- Listeria infection (Listeriosis)
More Guidelines
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