Listeria

Question 1

Presentations

Answer 1

Unwell, febrile pregnancy woman
Mostly in third trimester
1/3 may be asymptomatic

Question 2

Lab investigations

Answer 2

Blood culture

Gram stain and cultures of genital tract

Question 3

Treatment

Answer 3

Amoxicillin/ampicillin for 14 days (>2g, 4-6hrly, IV) + gentamicin for 14days
Consider delivery

Question 4

Mortality rate of fetus

Answer 4

In second and third trimester

Risk of fetal mortality 40-50%

Question 5

Asymptomatic but at high risk of listeria who have ingested food implicated in an outbreak treatment

Answer 5

Amoxicillin orally (2-3 gram/day) Or strimethoprim-sulphamethoxazole for 7 days

Question 6

Neonatal symptoms of listeria

Answer 6

Placental, cord or post-pharyngeal granulomas
Multiple small skin granuloma
Meh at < 34/40
Pneumonitis
Purulent conjunctivitis

Question 7

Mortality rate of infants born alive with listeria

Answer 7

3-60%
Early onset disease - preterm birth (mort 20-60%)
Late onset occurs in term infants (mortality is 10-20%)

Question 8

High risk listeria foods

Answer 8

Unpasteurized milk
Pate, dips and soft cheeses
Chilled precooked seafoods
Precooked meats and meat products which are eaten without further cooking or heating
Uncooked or smoked seafood
Pre-prepared salads and coleslaws
Raw eggs

Question 9

Listeria infection Australia

Answer 9

7/300,000

Question 10

Incubation period

Answer 10

1-67 days, median 8 days, with approx 6/52 for pregnancy-associated cases