Listeriosis

Listeriosis is an infectious disease from the group of zoonoses; Characterized by polymorphism of clinical manifestations. Acute forms occur in the form of purulent meningitis, meningoencephalitis, sepsis, chronic - more often as a recurrent inflammation of the urinary tract. The alimentary path of infection prevails.

Etiology, pathogenesis. Listeria - short Gram-positive rods, aerobes, stable in the external environment, sensitive to penicillin, tetracyclines, erythromycin, levomycetin. Gateway infection is the mucosa of the digestive tract. In some cases, a healthy carriage of listeria occurs. With the penetration of Listeria into the blood, a septic disease can develop, with the introduction of CNS, meningitis or meningoencephalitis occurs. Listeria can persist for a long time in the kidneys, which is important in pregnant women (possibly intrauterine infection of the fetus).

Symptoms, course. The incubation period lasts 2-4 weeks. Acute forms of listeriosis start suddenly: chills, fever, headache, irritability, pain in the muscles. The disease often occurs with exanthema. Rash large-spotted or erythematous, thickens in the area of ​​large joints, on the face forms a figure of "butterfly". With glandular forms, in addition, there is an increase and soreness of the peripheral lymph nodes. With nervous forms, meningeal symptoms are observed, and sometimes signs of encephalitis. Cerebrospinal fluid has a purulent character. The liver and spleen are enlarged. Sometimes in the clinical picture of listeriosis, the symptoms of acute gastroenteritis, pyelitis, endocarditis come to the fore. Listeriosis of newborns is difficult, with a mortality rate of up to 50%. High fever, shortness of breath, cyanosis, inflammation of the upper respiratory tract, specific listeriosis pneumonia, often complicated by purulent pleurisy. The liver and spleen are enlarged, jaundice, sometimes exanthema, appears in some patients. Often the central nervous system is involved.

In chronic forms, listeria can remain in the human body for a long time without causing significant clinical changes. Sometimes they cause exacerbation in the form of light flu-like diseases or exacerbation of chronic pyelitis. With the weakening of the body (treatment with corticosteroids, immunosuppressants), they can cause an exacerbation that occurs as a severe generalized infection. Clinical diagnosis is difficult. The most convincing proof of the disease is the isolation of the pathogen from the blood, cerebrospinal fluid, amniotic fluid, and pharyngeal swabs. Serological examination is of less importance, since listeria are antigenically similar to other microorganisms.

Treatment. In acute forms of listeriosis, antibiotics of the tetracycline group are prescribed in 0.2-0.3 g in 6 hours for 7-10 days, penicillin (400,000 units every 4-6 hours), erythromycin (0.25 g after 6 hours ) For 8-10 days. When treating pregnant women in the first 3 months tetracycline is not prescribed (the risk of teratogenic effects).

The prognosis for ferruginous forms is favorable. In pregnant women, listeriosis can lead to severe fetal lesions. After listeriogenic meningoencephalitis there may be persistent residual phenomena from the side of the central nervous system.

Prevention. Fight against listeriosis of farm animals. Pregnant women working in animal husbandry are temporarily transferred to work outside of contact with animals. Specific prophylaxis is not developed.