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Listeriosis

A foodborne infection caused by Listeria monocytogenes that can be severe in pregnancy and immunocompromised hosts.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Listeriosis?

Listeriosis is an infection caused by Listeria monocytogenes, a Gram-positive intracellular bacterium found ubiquitously in soil, water, and animals. Unlike most foodborne pathogens, Listeria can grow at refrigeration temperatures (psychrotrophic), making contaminated refrigerated ready-to-eat foods particularly hazardous.

Transmission occurs primarily through ingestion of contaminated foods. High-risk foods include unpasteurized dairy products, soft cheeses, deli meats, hot dogs, smoked seafood, refrigerated pâtés, and raw/undercooked sprouts. Vertical transmission occurs in pregnancy with serious fetal consequences. Direct contact (e.g., farm animals) is rare.

Clinical presentations vary by host. Healthy adults usually develop mild febrile gastroenteritis. Invasive listeriosis occurs in pregnant women (can cause miscarriage, stillbirth, neonatal sepsis), the elderly, and immunocompromised hosts (transplant recipients, cancer, HIV, alcohol misuse). Invasive forms include bacteremia, meningitis, meningoencephalitis (with brainstem rhomboencephalitis as a hallmark), and focal infections.

Symptoms

Febrile gastroenteritis: fever, watery diarrhea, headache, myalgia (incubation 24 hours)
Pregnancy: flu-like illness, fever, myalgia (mother often mildly ill)
Fetal complications: miscarriage, stillbirth, preterm labor, neonatal sepsis
Neonatal early-onset sepsis (granulomatosis infantiseptica)
Neonatal late-onset meningitis (1-3 weeks after birth)
Bacteremia in elderly/immunocompromised: fever, chills, malaise
Meningitis: fever, headache, neck stiffness, altered mental status
Rhomboencephalitis: cranial nerve palsies, ataxia, decreased consciousness
Focal infections: endocarditis, brain abscess, septic arthritis, osteomyelitis
Long incubation for invasive disease (median 11 days, up to 70 days)

Risk Factors

Pregnancy (10-20 fold higher risk)
Age over 65 years
Newborns (especially preterm)
Immunocompromised state: HIV/AIDS, transplant recipients, cancer (especially hematologic)
Corticosteroid or biologic therapy (TNF-alpha inhibitors)
Diabetes mellitus, chronic kidney/liver disease
Iron overload (hemochromatosis)
Alcohol use disorder
Achlorhydria or PPI use
Consumption of high-risk foods: unpasteurized dairy, soft cheeses, deli meats, smoked seafood, sprouts
Outbreaks linked to contaminated processed foods

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Pregnant woman with febrile illness, especially after eating high-risk foods
  • Fever, headache, neck stiffness in immunocompromised host
  • Decreased fetal movements with maternal fever
  • Neonate with sepsis or meningitis symptoms
  • Cranial nerve palsies, ataxia, altered consciousness
  • Persistent fever after recent high-risk food consumption
  • Outbreak alert with prior consumption of implicated food
  • Severe gastroenteritis in high-risk patient
  • Fever with focal neurological deficits

Treatment Methods

01
Empirical IV ampicillin (or penicillin G) for invasive disease
02
Add gentamicin for synergy in severe disease (meningitis, endocarditis)
03
Trimethoprim-sulfamethoxazole: alternative for penicillin allergy
04
Duration: bacteremia 14 days, meningitis 21 days, endocarditis 4-6 weeks, brain abscess 6-8 weeks
05
Pregnancy: ampicillin to cross placenta and treat fetal infection
06
Neonatal listeriosis: ampicillin plus gentamicin
07
Cephalosporins are NOT effective (intrinsic resistance) — common pitfall in empirical sepsis regimens
08
Hospitalization for invasive disease
09
Supportive care: hydration, antipyretics, monitoring
10
Follow-up cultures and clinical reassessment
11
Public health reporting and outbreak investigation
12
Prevention education: avoid high-risk foods in pregnancy and immunocompromised
13
Food safety: cook deli meats and hot dogs to 74°C, separate raw foods, refrigerate properly
14
Pregnant women: avoid unpasteurized dairy, soft cheeses, pâté, refrigerated smoked seafood
15
Recall awareness: monitor food safety alerts

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.