What Is Listeriosis?
Listeria monocytogenes is the most prevalent cause of listeriosis, while some cases have also been reported with L. ivanovii and L. grayi. Listeriosis can result in lasting injury or even fatality in severe sickness, such as meningitis (inflammation of the fluid and meninges), encephalitis ( inflammation of the brain), or severe sepsis. The elderly, fetuses, newborns, and people with impaired immune systems are among those most vulnerable to serious illness. Preterm delivery is common, and it can result in spontaneous abortion or stillbirth in pregnant women. Anybody can develop a fever and mild, self-limiting gastroenteritis from listeriosis.
What Are the Symptoms of Listeriosis?
The person who is afflicted and the area of the body that is affected determine the signs and symptoms of a listeria infection.
People 65 years of age or older, those with compromised immune systems, and expectant mothers and their unborn children are the most probable groups to become ill from the bacteria. Although other people can contract Listeria, they hardly ever get very sick.
1. Invasive Disease:
Bacteria are considered invasive when they have spread outside of the intestines. When Listeria has increased outside of the intestines, invasive listeriosis results. Within two weeks of consuming food tainted with Listeria, invasive disease symptoms typically manifest.
Symptoms that pregnant people usually experience include:
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High temperature.
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Flu-like symptoms, including weariness and aches in the muscles.
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Usually, pregnant women have minimal symptoms. Some pregnant women never experience any symptoms.
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On the other hand, infection during pregnancy typically results in miscarriage, stillbirth, early delivery, or potentially fatal illness of the unborn child.
Nonpregnant individuals usually experience the following symptoms:
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High temperature.
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Flu-like symptoms, including weariness and aches in the muscles.
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Head pain.
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Tight neck.
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Bewilderment.
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Abrupt imbalance.
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Non-pregnant individuals may experience severe symptoms.
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Invasive listeriosis claims the lives of nearly one in twenty non-pregnant patients.
2. Intestinal Disease:
Intestinal illnesses can also be caused by listeria. Laboratory testing for Listeria is not a routine procedure, which contributes to the low diagnosis rate of this type of sickness.
After consuming food contaminated with Listeria, symptoms of intestinal disease typically appear 24 hours later and last between one and three days.
The symptoms of intestinal disease include the following
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Diarrhea and vomiting.
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Most symptoms are not too severe.
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Nonetheless, invasive disease can occur in some patients with intestinal disorders.
3. Neonatal Listerial Infection:
Unlike maternal disease, prenatal and neonatal infection is aggressive and usually fatal, with an average death rate of 20 % to 30 %. Meningitis, sepsis (abnormal body response to an infection), or pneumonia (lung infection) can result from a neonatal listerial infection. The majority of neonates present with respiratory distress, fever, rash, jaundice, or lethargy, though this might vary. Granulomatousis infantiseptica, an uncommon, intense, widespread form of the disease marked by extensive microabscesses and granulomas, is the diagnostic sign of newborn listerial infection.
There have also been reports of late neonatal infections, which happen more than five to seven days following delivery. This frequently manifests as a meningeal disease. Typically, mothers who had uneventful pregnancies give birth to healthy, full-term infants who have late-onset listeriosis. Since bacteria are infrequently separated from the mother's vaginal tract, the root cause of listerial infection in this population may be the environment or the mother's alimentary tract.
What Are the Causes of Listeriosis?
Listeria monocytogenes is found everywhere in the environment. The consumption of tainted food products is the primary method of contracting Listeria. It has been determined that uncooked meat, dairy goods, vegetables, fruit, and shellfish all contain listeria. Potential risks include soft cheeses and unpasteurized dairy products; however, outbreaks, including post-pasteurized milk, have been documented.
On rare occasions, listeriosis can manifest as cutaneous listeriosis. Veterinarians who treat sick animals, usually following a listerial abortion, are primarily the only people who contract this infection, which develops from direct contact with L. monocytogenes through the intact skin.
Because listeria has an intracellular life cycle, it is a distinct pathogen. Listeria can enter the host without compromising the functionality of the gastrointestinal tract once it has been consumed and is phagocytosed by gastrointestinal cells. The organism quickly divides and presses up as opposed to the cell membrane once it has entered the host cytoplasm, where it might be swallowed by nearby cells. Without contact with neutrophils, antibodies, or antibiotics in the extracellular fluid, Listeria can grow and spread by following this sequence of events. This explains the possibility of a moderate or even asymptomatic maternal listerial disease. The host's defense against Listeria is called cell-mediated immunity, and conditions like pregnancy that lower cell-mediated immunity can put a person at risk of contracting the infection.
How to Diagnose Listeriosis?
A bacterial culture, a laboratory test, is typically used to identify listeriosis when the germs grow from a bodily tissue or fluid, including blood, spinal fluid, or the placenta.
When a pregnant patient presents with fever, blood cultures should be explored, especially if there are gastrointestinal or flu-like symptoms present. This is because listeriosis in pregnancy is a dangerous condition that can be difficult to identify. If there is a high suspicion of listerial infection, clinicians should consider initiating treatment after getting cultures.
How to Manage Listeriosis Perinatally?
There are no planned antibiotic regimens since listeriosis is an uncommon disease. An antibiotic must attach to the penicillin-binding protein 3 (PBP3) of Listeria, which results in cell death, to be functional against the bacterium. It also needs to enter the host cell and sustain significant intracellular concentrations; it must do so without significantly changing pH or concentration. The antibiotic's ability to pass the placenta at a sufficient concentration is an additional consideration during pregnancy.
Most commonly, Penicillin, Ampicillin, and Amoxicillin are medications used to treat listeriosis. These medications do enter cells and block a number of PBPs. To ensure sufficient penetration of the placenta and umbilical cord, high dosages are typically utilized. When Gentamicin is incorporated into therapy regimens, certain in vitro studies indicate a beneficial impact; nevertheless, animal models do not consistently demonstrate a combined benefit. Considering Gentamicin's toxicity, some medical professionals are still determining whether it is worthwhile to include it in the treatment plan.
For treatment during pregnancy, most specialists advise taking six grams or more of Ampicillin daily. This dosage penetrates the placenta sufficiently and allows for appropriate intracellular penetration. Numerous case reports advocate a dosage of two grams every six to eight hours.
Treatment with Trimethoprim or Sulfamethoxazole provides a substitute for those allergic to Penicillin. Antibiotics such as Erythromycin, Meropenem, Linezolid, and Rifampin have also been utilized in listeriosis case reports. Due to their inability to bind to PBP3, cephalosporins are useless against Listeria.
It is unknown how long therapy should last when a woman is pregnant. The length of therapy has been reported in case reports to range from two weeks to ongoing care until birth. Recurrences have been documented in immune-compromised following a two-week course of Penicillin therapy. Other factors to take into account throughout pregnancy include the placenta's proper care and the possibility of persistent infections in the fetus and placenta. There has been worry that if antibiotic therapy is stopped, placental infection could worsen even though it could not be clinically noticeable. Because of this, some professionals advise receiving treatment for at least three to four weeks during pregnancy.
Conclusion:
Listeriosis is a highly uncommon infection caused by bacteria. Pregnant women, fetuses, newborns, elderly individuals, and those with compromised immune systems may all have significant consequences from it. Immediately consult the doctor if individuals experience any signs of listeriosis. Hand hygiene, properly cooked meats, and clean fruits and vegetables are all ways to help stave off a listeriosis infection.
