Listeria monocytogenes bacteremia in third trimester of pregnancy:case report with literature review / 中华全科医师杂志

ABSTRACT

One case of Listeria monocytogenes bacteremia in third trimester of pregnancy admitted in Zhongnan Hospital was reported .And 25 cases of maternal listeriosis were retrieved from domestic literature search up to March 2017.The clinical features of 26 cases were analyzed .The newly reported case was a 27-year-old primigravida at 37 weeks 5 days of gestation presenting with fever for 23 days. Listeria monocytogenes was identified in blood culture .She was treated with intravenous piperacillin sodium and tazobactam sodium for 3 weeks and recovered .At 39 weeks 4 days of gestation, she gave birth of a male baby by vaginal delivery .The newborn baby was healthy with negative Listeria monocytogene in blood culture.The age of onset of all 26 cases was (30.2 ±4.7)years.There were 1, 13 and 12 patients with listeriosis diagnosed in the first, second and third trimester of pregnancy , respectively.The median time from onset to symptom presentation was 2 days.Clinical manifestations included fever (92%,24/26), leukocytosis (75%,18/24), abdominal pain (27%,7/26), fetal movement decrease or lose (23%,6/26) and vaginal bleeding (15%,4/26).Listeria monocytogenes were isolated from blood (11 cases), uterus swab (7 cases), amniotic fluid (2 cases) and so on.High proportion of adverse pregnancy outcomes occurred (88%,22/25).All gravidae recovered well after the termination of pregnancy .The empirical antibiotics did not cover those sensitive to listeria in all patients .Patients with maternal listeriosis often presented with acute fever and a high incidence of adverse pregnancy outcomes , however, empirical antibiotics can hardly cover Listeria monocytogene.Thus, clinicians should improve awareness of listeriosis to avoid missed diagnosis and misdiagnosis .