#idBoardreview pregnant female presents w/ fever, nausea, vomiting, diarrhea. She recently went to picnic and avoided salads/deli meat but ate grilled chicken, 🥖, caramel apple, 🌽. Blood cultures results are shown. Diagnosis? #medEd #IDMedEd
#listeria (small gram+rod) due to caramel apple
#listeria grows rapidly on blood agar, tumbling motility, need to inform lab if suspicious, can be mistaken for strep or diptheroids and can be disregarded as contaminant. Will grow on refrigerated food
#listeria human transmission is via contaminated food or from pregnant female to fetus or neonate. High risk groups: pregnant, neonates, >60 yo with cell mediated immunity or steroids/antiTNF. Dz:meningitis, brain abscess, rhomboencephalitis, or bacteremia, gastroenteritis
Tx: ampicillin (add gent for cns infection or Endocarditis); in penicillin allergic pt: tmp/smx; tip if a pt is on tmp/smx for pneumocystis prophylaxis: it prevents listeriosis
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