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General Reference

Nejm 1996;334:770

Pathophys and Cause

Cause:Listeria spp

Pathophys:Intracellular pathogenesis, usually picked up by gut macrophages and spread from there

Epidemiology

Present in most soils, animal gi tracts, and raw milk from infected cows, though it can occur even if pasteurized (Nejm 1997;336:100), or cheese (Mexican cheese epidemic in Calif—Nejm 1988;319:823)

Increased in pregnant women, elderly, neonates, and immunocompromised (Ann IM 1992;117:466)

Signs and Symptoms

Sx:Of sepsis, meningitis (Pediatric Meningitis)

Si:Sepsis, meningitis esp in children < age 6 mo (Pediatric Meningitis)

Complications

Lab: CSF: Gram-positive rods, tumbling motility; often 80% polys

Lab and Xray

Meningitis, sepsis, spontaneous abortion

Treatment

Rx:Ampicillin 1st choice; Tm/S a 2nd choice or used w ampicillin