Listeriosis in pregnancy: a challenge in diagnosis.

Listeriosis is a rare foodborne infection caused by Listeria monocytogenes It has been reported to be commonly found among the obstetric population, immunocompromised group and elderly, presumably due to the lower immunity status in these populations. Presentation in pregnancy is usually non-specific like fever, diarrhoea, respiratory tract symptoms and preterm rupture of membrane. These make the diagnosis challenging and may delay the correct management. We present a case of a female in her early 40s, gravida 4 para 0+3 at 27 weeks who presented with fever. She later developed preterm rupture of membrane 24 hours after admission. The leaking of liquor later changed from clear to meconium stained raising the suspicion of listeria chorioamnionitis, necessitating an emergency preterm delivery via caesarean section. The newborn acquired listeria infection and required ventilation support. He subsequently was discharged from neonatal unit after nearly 3 months of life.

Listeria monocytogenes cholangiohepatitis in a lactating Holstein cow.

OBJECTIVE: To describe a unique presentation of systemic Listeria monocytogenes infection in a lactating adult Holstein cow. ANIMAL: 3-year-old second-parity female Holstein, 200 days in milk. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: A 3-year-old Holstein dairy cow was presented for decreased appetite, decreased milk production, and pyrexia. Blood work displayed marked abnormalities in liver-associated parameters. A diagnosis of L monocytogenes cholangiohepatitis was made following liver biopsy, histopathology, and bacterial culture. TREATMENT AND OUTCOME: The cow was treated with systemic antimicrobial and antipyretic therapy. The cow was discharged to continue treatment on farm, and at time of last communication with the owner, the cow was doing very well, with full resolution of clinical signs. CLINICAL RELEVANCE: This case report describes a novel presentation of L monocytogenes infection in an adult bovine. L monocytogenes cholangiohepatitis should be considered a rare differential diagnosis in cattle presenting with evidence of pyrexia and liver disease.

Non-perinatal listeriosis: Changes in frequency, clinical spectrum and prognostic factors.

INTRODUCTION: Listeria monocytogenes infection is a severe disease affecting mainly aged people and patients with immune depression. The incidence of listeriosis seems to be increasing. In the present study cases of listeriosis from two hospitals are analyzed with the aims of studying changes in its incidence, clinical forms of presentation and possible factors associated with mortality. METHODS: Retrospective multicentric study of patients with culture-proven listeriosis in two university hospitals in Madrid between 1977 and 2021. Epidemiological and clinical variables, as well as factors for immune depression, complementary studies and treatments were registered. Factors associated with mortality were analyzed. RESULTS: A total of 194 cases of listeriosis were analyzed. The incidence of listeriosis among in-patients increased through the study period, with a significant drop in the number of cases in 2020. The most common clinical presentations were isolated bacteriemia (37.1%) and central nervous system involvement (CNS) (36.6%). Symptoms of gastroenteritis occurred in 21% of cases. Other focal infections were present in 16.5% of patients, the most frequent were spontaneous bacterial peritonitis (8.2%), cholecystitis (2.1%), respiratory infection (1.5%) and vascular prothesis infection (1.5%). In-hospital mortality was 24.7%. Independent factors associated with mortality at admission were age (Odds Ratio [OR] 1.027, 95% confidence interval [IC95%] 1.003-1.056) and a diagnosis of a solid tumor (OR 3.525, IC95% 1.652-7.524). CONCLUSIONS: This study confirms an increasing incidence of listeriosis in our millieu. The most common clinical presentations were isolated bacteriemia and central nervous system involvement. In-hospital mortality was associated with age and the diagnosis of a solid tumor.

Clinical significance of rapid detection and diagnosis of Listeria infection in blood with mass spectrometry.

OBJECTIVE: Listeriosis is caused by the bacterium, Listeria monocytogenes, and is a significant health concern because of high hospitalization and mortality rates. This study reports seven cases of pregnancy-associated listeriosis diagnosed with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry performed on infection-positive blood culture. METHODS: Blood culture-positive samples of seven patients whose pregnancy was complicated by Listeria infection and treated at Xuanwu Hospital of Capital Medical University between January 2016 and December 2021 were analyzed retrospectively. Strains identified by MALDI-TOF mass spectrometry were compared with colony identification results. Identification accuracy and consistency were assessed. RESULTS: A total of seven strains of Listeria were collected from seven pregnant women presented with fever (37.6-39.9°C). Clinical abnormalities included abnormal liver function, emaciation, hypoalbuminemia, hypocalcemia, hypokalemia, hyponatremia, ketosis, mild to moderate anemia, leukopenia, and thrombocytopenia. Compared with the traditional culture method, MALDI-TOF mass spectrometry led to much earlier identification (4-6 h vs. 3-4 days) with 100% identification accuracy. Of the seven pregnancies complicated by Listeria, only two led to live births. Of the five fetal deaths, three occurred in the second trimester. CONCLUSION: In this series of pregnancy-associated listeriosis cases, the fetal mortality rate was 71%. MALDI-TOF mass spectrometry is a valuable method that can identify Listeria from blood culture rapidly and accurately.

Listeria monocytogenes an Emerging Pathogen: a Comprehensive Overview on Listeriosis, Virulence Determinants, Detection, and Anti-Listerial Interventions.

Listeria monocytogenes, the third most deleterious zoonotic pathogen, is a major causative agent of animal and human listeriosis, an infection related to the consumption of contaminated food products. Even though, this pathogen has been responsible for the outbreaks of foodborne infections in the early 1980s, the major outbreaks have been reported during the past two decades. Listeriosis infection in the host is a rare but life-threatening disease with major public health and economic implications. Extensive reports on listeriosis outbreaks are associated with milk and milk products, meat and meat products, and fresh produce. This bacterium can adapt to any environmental and stress conditions, making it a prime causative agent for major foodborne diseases. The pathogen could survive an antibiotic treatment and persist in the host cell, thereby escaping the standard diagnostic practices. The current review strives to provide concise information on the epidemiology, serotypes, and pathogenesis of the L. monocytogenes to decipher the knowledge on the endurance of the pathogen inside the host and food products as a vehicle for Listeria contaminations. In addition, various detection methods for Listeria species from food samples and frontline regimens of L. monocytogenes treatment have also been discussed.

Placental Listeriosis: Case Report and Literature Review.

Listeria monocytogenes, a foodborne, facultative, intracellular gram-positive bacillus, is one of 17 species of the Listeria genus and was responsible for the world's largest outbreak of listeriosis in 2017-2018 in South Africa. Listeria monocytogenes tends to cause mild gastrointestinal symptoms in healthy individuals. However, pregnancy-associated listeriosis can be fatal to the fetus and can lead to serious adverse effects in the neonate. Listeria monocytogenes has an affinity for the placenta, as opposed to other nonreproductive organs. Herein, we present a case of placental listeriosis diagnosed in a 33-year-old female, parity 4, with unknown gestational age during the listeriosis outbreak in South Africa in 2017-2018. The patient presented with pregnancy-related complications and underwent a caesarean section. Morphological features demonstrated acute suppurative villitis and intervillositis with a heavy load of gram-positive bacilli, which is highly suggestive of placental listeriosis. Multiplex polymerase chain reaction confirmed the presence of L. monocytogenes.

Listeriosis in a goat herd.

Two 3-week-old goat kids from a herd of ~50 to 60 goats were examined by a veterinarian. The goats were in lateral recumbency with an inability to rise. Unilateral cranial nerve deficiencies included cervical rotation, nystagmus, ptosis, facial paralysis, and absence of palpebral reflex. One of the 2 kids had a fever. The kids died and necropsy examinations were performed. Histopathology findings were highly suggestive of Listeria monocytogenes infection, which was confirmed by bacterial culture. This case suggests that listeriosis should be included in the differential diagnosis for goats with neurological signs even if they are not fed silage or haylage and are kept in a clean barn.

Listériose dans un troupeau de chèvres. Deux chevreaux de 3 semaines d'un troupeau d'environ 50 à 60 chèvres ont été examinés par un vétérinaire. Les chèvres étaient en décubitus latéral avec une incapacité à se lever. Les déficiences unilatérales des nerfs crâniens comprenaient une rotation cervicale, du nystagmus, une ptose, une paralysie faciale et l'absence de réflexe palpébral. Un des 2 chevreaux avait de la fièvre. Les chevreaux sont morts et des nécropsies ont été effectués. Les résultats de l'histopathologie étaient très évocateurs d'une infection à Listeria monocytogenes, qui a été confirmée par culture bactérienne. Ce cas suggère que la listériose devrait être incluse dans le diagnostic différentiel pour les chèvres présentant des signes neurologiques même si elles ne sont pas nourries avec de l'ensilage ou de l'ensilage préfané et sont gardées dans une étable propre.(Traduit par Dr Serge Messier).

Identification by High-Throughput Real-Time PCR of 30 Major Circulating Listeria monocytogenes Clonal Complexes in Europe.

Listeria monocytogenes is a ubiquitous bacterium that causes a foodborne illness, listeriosis. Most strains can be classified into major clonal complexes (CCs) that account for the majority of outbreaks and sporadic cases in Europe. In addition to the 20 CCs known to account for the majority of human and animal clinical cases, 10 CCs are frequently reported in food production, thereby posing a serious challenge for the agrifood industry. Therefore, there is a need for a rapid and reliable method to identify these 30 major CCs. The high-throughput real-time PCR assay presented here provides accurate identification of these 30 CCs and eight genetic subdivisions within four CCs, splitting each CC into two distinct subpopulations, along with the molecular serogroup of a strain. Based on the BioMark high-throughput real-time PCR system, our assay analyzes 46 strains against 40 real-time PCR arrays in a single experiment. This European study (i) designed the assay from a broad panel of 3,342 L. monocytogenes genomes, (ii) tested its sensitivity and specificity on 597 sequenced strains collected from 24 European countries, and (iii) evaluated its performance in the typing of 526 strains collected during surveillance activities. The assay was then optimized for conventional multiplex real-time PCR for easy implementation in food laboratories. It has already been used for outbreak investigations. It represents a key tool for assisting food laboratories to establish strain relatedness with human clinical strains during outbreak investigations and for helping food business operators by improving their microbiological management plans. IMPORTANCE Multilocus sequence typing (MLST) is the reference method for Listeria monocytogenes typing but is expensive and takes time to perform, from 3 to 5 days for laboratories that outsource sequencing. Thirty major MLST clonal complexes (CCs) are circulating in the food chain and are currently identifiable only by sequencing. Therefore, there is a need for a rapid and reliable method to identify these CCs. The method presented here enables the rapid identification, by real-time PCR, of 30 CCs and eight genetic subdivisions within four CCs, splitting each CC into two distinct subpopulations. The assay was then optimized on different conventional multiplex real-time PCR systems for easy implementation in food laboratories. The two assays will be used for frontline identification of L. monocytogenes isolates prior to whole-genome sequencing. Such assays are of great interest for all food industry stakeholders and public agencies for tracking L. monocytogenes food contamination.

Spontaneous bacterial peritonitis caused by Listeria monocytogenes: A rare infection with very high leukocyte counts in ascitic fluid-case report and review of the literature.

We present a rare case of Listeria monocytogenes-induced spontaneous bacterial peritonitis (SBP) in cirrhosis. Examination of the patient's peritoneal fluid revealed an extremely high leukocyte count. We suspect, that the patient belongs to 1% of individuals in which Listeria monocytogenes is part of the intestinal flora. Cephalosporins as empiric antibiotics have a Listeria gap. A combination of aminopenicillin and aminoglycoside is recommended. Therefore, early microbiological diagnosis from ascites and blood is essential. Listeria should be considered as a rare cause of SBP, especially in case of very high leukocyte count in peritoneal fluid or lack of response to empiric therapy.

Rapport de cas Mononuclear pleocytosis and meningoencephalitis caused by Listeria monocytogenes in an adult horse.

Clinical disease caused by infection with Listeria monocytogenes is rare in adult horses, and there is a paucity of ante-mortem clinicopathologic changes for this species reported in the literature. Confirmatory diagnosis is difficult and often requires post-mortem sampling of the brainstem. This report details a case of meningoencephalitis caused by Listeria monocytogenes in an adult American quarter horse gelding presenting with central neurologic signs. Pre-mortem analysis of the cerebrospinal fluid revealed a mononuclear, primarily lymphocytic, pleocytosis, which is a reported finding in other species with listeriosis. Post-mortem histopathologic changes of the brainstem were characteristic of listeriosis, and infection was confirmed with immunohistochemical labeling and bacterial culture. Key clinical message: Listeriosis should be included as a differential diagnosis in neurologic horses with mononuclear pleocytosis identified on cerebrospinal fluid analysis.

Pléocytose mononucléaire et méningo-encéphalite causées par Listeria monocytogenes chez un cheval adulte. La maladie clinique causée par une infection à L. monocytogenes est rare chez les chevaux adultes, et il y a peu de changements clinico-pathologiques ante-mortem rapportés dans la littérature pour cette espèce. Le diagnostic de confirmation est difficile et nécessite souvent un prélèvement post-mortem du tronc cérébral. Ce rapport détaille un cas de méningo-encéphalite causée par L. monocytogenes chez un hongre quarter horse américain adulte présentant des signes neurologiques centraux. L'analyse pré-mortem du liquide céphalo-rachidien a révélé une pléocytose mononucléaire, principalement lymphocytaire, qui est une trouvaille rapportée chez d'autres espèces atteintes de listériose. Les modifications histopathologiques post-mortem du tronc cérébral étaient caractéristiques de la listériose et l'infection a été confirmée par un marquage immunohistochimique et une culture bactérienne.Message clinique clé :La listériose doit être incluse comme diagnostic différentiel chez les chevaux avec signes neurologiques présentant une pléocytose mononucléaire identifiée lors de l'analyse du liquide céphalo-rachidien.(Traduit par Dr Serge Messier).

Listeria rhombencephalitis mimicking stroke in a patient with giant cell arteritis.

Listeria monocytogenes sometimes causes central nervous system infections. However, rhombencephalitis is a rare form of L. monocytogenes infection. Its clinical symptoms and magnetic resonance imaging (MRI) findings are often similar to those of vertebrobasilar stroke. We present the case of a 79-year-old woman with Listeria rhombencephalitis presenting with rhinorrhea and productive cough. She had giant cell arteritis (GCA) treated with prednisolone and methotrexate. She was admitted for loss of appetite, rhinorrhea, and productive cough. These symptoms were alleviated without specific treatment; however, she suddenly developed multiple cranial nerve palsies, and MRI showed hyperintense signals on diffusion-weighted imaging and hypointense signals on apparent diffusion coefficient in the brainstem. Ischemic stroke due to exacerbation of GCA was suspected, and treatment with intravenous methylprednisolone was initiated; however, seizures occurred, and a lumbar puncture was performed. Cerebrospinal fluid and blood cultures revealed L. monocytogenes, and she was diagnosed with Listeria rhombencephalitis. Although antibiotic treatment was continued, the patient died. Thus, when patients with rhinorrhea or productive cough develop sudden cranial nerve palsy, Listeria rhombencephalitis should be considered as a differential diagnosis, and lumbar puncture should be performed.

Risk factors associated with early mortality after recovery from severe listeriosis: a multicentre 17-year longitudinal study.

BACKGROUND: Listeriosis presents high rates of mortality but prognostic factors for early prevention are not well established. The aim of this study was to analyse factors associated with in-hospital and early mortality of adults after recovery from severe infection caused by Listeria monocytogenes. METHODS: All cases of listeriosis notified in the province of Granada from January 2005 to December 2021, including 9 centres, were included. Only laboratory confirmed non-neonatal cases were considered. Follow-up was conducted by accessing medical records and epidemiological data. Bivariate and multivariate analyses were conducted to detect potential risk factors associated to in-hospital mortality, 1-year, and 5-year early death after recovery. Multivariate Cox regression models were performed. A total of 206 patients were identified. RESULTS: The mean age was 62.6 years (sd, 18.8). A high frequency of comorbidities (88.3%) was observed, and 42 patients (20.4%) died during hospitalisation. Of the patients who recovered from acute infection, 26 (15.9%) died during the following year and 47 (28.7%) died during the following 5 years. The main factors associated with early mortality after recovery were age (HR: 1.03; 95% CI 1.02-1.07), diabetes mellitus (HR 1.86, 95% CI 1.01-3.44), chronic kidney disease (HR 3.96, 95% CI 1.87-8.38), liver disease (HR 3.62, 95% CI 1.64-8.51), and cancer (HR 3.76, 95% CI 1.90-7.46). CONCLUSION: Listeriosis is associated with high early post-recovery mortality. Our study describes the main prognostic factors, which may help to improve preventive follow-up strategies of adults with severe listeriosis.

[Listeria endocarditis]. / Die Listerienendokarditis.

BACKGROUND: Bacterial infections caused by Listeria monocytogenes are rarely observed in routine clinical practice. Symptoms can range from comparatively unspecific to severe, septic courses of disease with cardiac, pulmonary, abdominal or bone involvement. CASE REPORT: A 74-year-old male patient with a history of mitral valve replacement and pacemaker implantation presented to the emergency department with high fever and disturbed coagulation. Transesophageal echocardiography revealed mitral valve endocarditis with early abscess formation. In blood cultures, growth of Listeria monocytogenes was detected after 20 h. Despite immediately initiated calculated antibiotic therapy and following adaption to the resistogram, the mitral valve finding was progressive and cardiosurgical intervention became necessary. CONCLUSION: Diagnosis of endocarditis caused by Listeria requires structured collaboration between cardiologists, imaging and laboratory. This case report aims to increase awareness of potentially Listeria-induced organ manifestations.

Presentation and outcomes of Listeria-affected pregnancies in Johannesburg tertiary hospitals: A 2-year review.

OBJECTIVE: To describe maternal risk factors, presentations, peripartum findings, and pregnancy outcomes in Listeria monocytogenes-infected women. METHODS: A retrospective descriptive case review. The records of 51 pregnant women infected with listeriosis who delivered infants between February 1, 2016 and February 28, 2018 at three academic hospitals in Johannesburg, South Africa, were included. The diagnosis of listeriosis was made on maternal/neonatal-sampled blood or tissue cultures. RESULTS: Forty-eight (82.3%) Listeria infections of maternal and neonatal listeriosis were diagnosed on blood culture. The median gestational age at diagnosis was at a preterm gestation of 33 (20-43) weeks. Twenty-eight women (54.9%) had normal vaginal deliveries. Precipitous labor was described in 18 (39%) of these women. Fetal distress was the indication for cesarean section in 22 (41.2%) women. Meconium-stained amniotic fluid was found in 21 (61.7%) women at the time of delivery. The category of very low birth weight had 14 (27.4%) neonates with an Apgar score of less than 7 at 5 min. Maternal morbidities included chorioamnionitis (3 [5.8%]) and puerperal infections (7 [13.7%]). The HIV-positive anemic women had a tendency towards listerial infections. CONCLUSIONS: Symptoms of listeriosis were non-specific and diagnosis was detected on blood culture sampling. Risk factors included HIV seropositivity and were associated with puerperal infections and anemia.

Maternal sepsis caused by Listeria monocytogenes with a fatal fetal outcome.

Improving maternal and child health is a global priority. Although infection with Listeria monocytogenes (LM), a small facultative anaerobic, gram-positive motile bacillus is rare, when it infects the maternal-fetoplacental unit, it can result in adverse fetal sequelae such as chorioamnionitis, preterm labour, neonatal sepsis, meningitis and neonatal death. Pregnancy-associated listeriosis may present with a plethora of diverse, non-specific symptoms such as fever, influenza-like or gastrointestinal symptoms, premature contractions and preterm labour. It has a predilection for the second and third trimester of pregnancy, occurring sporadically or as part of an outbreak, most of which have involved unpasteurised dairy products, long shelf life products, contaminated ready-to-eat food, deli meats and soft cheeses. Strains belonging to the clonal complexes 1, 4 and 6 are hypervigilant and are commonly associated with maternal-neonatal infections. Maternal listeriosis occurs as a direct consequence of LM-specific placental tropism, which is mediated by the conjugated action of internalin A and internalin B at the placental barrier. The diagnosis is established from placental culture. Penicillin, ampicillin and amoxicillin are the antimicrobials of choice. It has a high fetal morbidity of up to 30%. The authors present the case of a multiparous woman in her early 20s presenting with sepsis and preterm premature rupture of her membranes at 21 weeks gestation. A live baby was delivered spontaneously and died shortly after birth. Placental cultures and postmortem examination were consistent with the diagnosis of disseminated Listeria infection. Due to the increased susceptibility of pregnant women for LM, a high index of clinical suspicion is required to establish the diagnosis and initiate appropriate antimicrobial therapy to reduce adverse fetal outcomes.

Fatal Listeria monocytogenes septicemia and meningitis complicated by Candida glabrata fungemia: a case report.

Listeria monocytogenes is a Gram-positive bacteria and etiological agent of listeriosis. It has the ability to colonize the intestinal lumen and cross the intestinal, blood-brain, and placental barriers, leading to invasive listeriosis responsible for septicemia and meningitis in subjects at risk such as patients with diabetes mellitus, the elderly, and immunocompromised individuals and, for maternal-neonatal infection in pregnant women. We report a rare case of L. monocytogenes septicemia and meningitis complicated by Candida glabrata fungemia on a patient with a history of type 2 diabetes mellitus, hypothyroidism, hypertension, chronic kidney failure, chronic ischemic vascular encephalopathy, and atrial fibrillation. Although adequate therapy was rapidly started with an initial partial clinical improvement, the patient suddenly experienced clinical worsening concomitantly with Candida septicemia resulting in a fatal outcome. To our knowledge, this is the first described case of an invasive L. monocytogenes infection complicated by Candida sepsis. We hypothesize that concomitant Candida infection may play a significant role in the pathogenesis and virulence of L. monocytogenes.

Clinical features and antibiotic treatment of early-onset neonatal listeriosis.

OBJECTIVE: To analyze the clinical features, efficacy of antibiotic treatment, and outcome of neonatal listeriosis. METHODS: This was a retrospective study that included all neonates diagnosed with listeriosis between January 2010 and December 2021. RESULTS: Nine male patients and five female patients were analyzed, including 11 preterm and 3 term infants. The mean gestational age was 34 ± 2.6 weeks (29 + 2-40 + 2 weeks), and the mean birth weight was 2392 ± 603 g (1370-3580 g). The maternal clinical manifestations included fever (13/14 [92.9%]), meconium-stained amniotic fluid (12/14 [85.7%]), and intrauterine fetal distress (11/14 [78.6%]). The neonates presented with fever (14/14 [100%]), generalized maculopapular rash (7/14 [50%]), and convulsions (8/14 [57.1%]). Laboratory tests showed leukocytosis (11/14 [78.6%]), monocytosis (9/14 [64.3%]), elevated C-reactive protein levels (13/14 [92.9%]), and thrombocytopenia (6/14 [42.9%]). Eight patients had central nervous system involvement, and Listeria monocytogenes was isolated from the blood in all cases. Empiric antibiotic therapy consisted of a combination of third-generation cephalosporins and penicillin or vancomycin. Four patients died, and 10 patients were cured. CONCLUSIONS: Preterm infants were more susceptible to listeria infection than term infants, with most having multiple organ injuries. Combined antibiotic application improved the effectiveness of treatment.

Brain abscess caused by Listeria monocytogenes: a case report and literature review.

BACKGROUND: Listeria monocytogenes (L. monocytogenes) is an opportunistic facultative anaerobic pathogen that is widely distributed in nature. Brain infection (meningitis and meningoencephalitis) and bacteremia are common clinical manifestations of listeriosis in elderly and immunocompromised individuals. Brain abscesses caused by L. monocytogenes are extremely rare. In this study, we describe a case of an older male who with a brain abscess caused by Listeria infection. CASE DESCRIPTION: We report a case of a 59-year-old male who was once diagnosed with acute cerebral infarction. The diagnose was changed after needle biopsy of the abscess and culture of L. monocytogenes. The patient was first empirically used the broad-spectrum antibiotic meropenem for 12 days (2 g Q8 h) until culture results were available, and then switched to oral trimethoprim/sulfamethoxazole 160/800 mg/12 h for further 2 weeks. The symptoms of slurred speech, numbness and impaired muscle strength of the right leg improved. Computed tomography (CT) and magnetic resonance imaging (MRI) examination were performed 2 weeks after operation showed smaller abscess and reduced perifocal edema. The patient was continued oral trimethoprim/sulfamethoxazole for 8 weeks. The remaining right arm dysfunction recovered. After six months, the patient had returned to normal daily activities and only exhibited weakness of the right fingers. CONCLUSIONS: Brain abscess caused by L. monocytogenes should be considered in patients who have risk factors for listeriosis. Pathogen infection, including with Listeria monocytogenes, should be taken into account when patients with impaired immune function exhibit hemiplegia and aphasia. Listeria infection should also be considered in immunocompetent patients. Performing needle biopsy or lesion resection and starting antibiotic therapy according to drug susceptibility testing in the early stage is key to treating this kind of disease.