Last reviewed: 25 Jun 2021
Last updated: 21 Jul 2021

Summary

Definition

History and exam

Other diagnostic factors

  • fever
  • diarrhea and abdominal pain
  • generalized malaise
  • flu-like symptoms in pregnancy
  • poor feeding (neonates)
  • meningismus
  • cranial nerve deficits
  • cerebellar signs
  • focal neurologic signs
  • seizures
  • hypotension
  • intrapartum fever
  • bleeding diathesis with hemorrhage
  • 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

  • CBC
  • urine pregnancy test
  • blood cultures
  • brain MRI
  • brain CT
  • cerebrospinal fluid (CSF) analysis

Investigations 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

Emerging tests

  • meningitis/encephalitis panel

Treatment algorithm

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

Charles C.J. Carpenter Professor of Infectious Disease

Chief, Infectious Diseases Division

Rhode Island Hospital and The Miriam Hospital

Alpert Medical School of Brown University

Assistant Dean for Outpatient Investigations

Professor of Molecular Microbiology and Immunology

Brown University

Providence

RI

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.

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