Chapter

Listeriosis

H. Hof

in Oxford Textbook of Medicine

Fifth edition

Published on behalf of Oxford University Press

ISBN: 9780199204854
Published online May 2012 | e-ISBN: 9780199570973 | DOI: http://dx.doi.org/10.1093/med/9780199204854.003.070637_update_002

Series: Oxford Textbooks

Listeriosis

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Listeriosis is caused by the Gram-positive bacillus Listeria monocytogenes, whose natural habitat is the soil. Consumption of soft cheeses, other dairy products, meat products, seafood, and vegetables is the principal route of infection. Patients at particular risk include those who are immunocompromised, very young, or very old. Pregnant women are also at risk, although they develop only mild disease, but the bacteria can be transmitted to the child either in utero or during birth, causing serious systemic disease.

Clinical features and diagnosis—the disease varies from a mild, influenza-like illness to fatal septicaemia and meningoencephalitis. Purulent, localized infections of any organ are sometimes seen. Diagnosis is confirmed by culture from blood, cerebrospinal fluid, or organ biopsies using enrichment and selective methods. Immunoassays and nucleic acid amplification techniques are used in specialized laboratories; serology is nonspecific and not helpful.

Treatment, prognosis, and prevention—aside from supportive care, the usual treatment of choice is high-dose intravenous ampicillin combined with an aminoglycoside, which must be administered for at least 2 weeks. The prognosis is poor, with mortality of up to 30%. Prevention depends upon those that are vulnerable avoiding high-risk foods. There is no vaccine.

Chapter.  2768 words. 

Subjects: Medical Microbiology and Virology ; Infectious Diseases

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