Listeriosis In Newborns

Neonatal listeriosis is either transplacental, intra- or postpartum acquired. The symptoms are those of a sepsis. The diagnosis is made by cultures in mother and child. The treatment is done with antibiotics and fed with ampicillin and aminoglycosides.

Neonatal listeriosis is either transplacental, intra- or postpartum acquired. The symptoms are those of a sepsis. The diagnosis is made by cultures in mother and child. The treatment is done with antibiotics and fed with ampicillin and aminoglycosides.

(Listeriosis). The neonatal listeriosis, either transplacentally, intra- or postpartum acquired. The symptoms are those of a sepsis. The diagnosis is made by cultures in mother and child. The treatment is done with antibiotics and fed with ampicillin and aminoglycosides. The in utero infection with Listeria monocytogenes can lead to fetal scattering with granuloma (z. B. skin, liver, adrenal glands, lymphoid tissues, lung, and brain). If a rash is present, it is called granulomatosis infantisepticum. For in utero or perinatal infection of the lungs occurs by aspiration or ingestion of amniotic fluid or vaginal secretions. This manifests itself in the first days of life with respiratory distress, shock, and a fulminant course. Symptoms and discomfort Infection of a pregnant women can be asymptomatic or having a primary, manifesting itself through flu-like symptoms bacteremia. In the fetus and newborn clinical presentation depends on the time and route of infection. There is often miscarriages, premature births among amnionitis (with characteristic brown and murky amniotic fluid), stillbirth or neonatal sepsis (sepsis in newborns: symptoms and complaints). The symptoms can be hours or days after birth (early start) or even manifest until after a few weeks. Newborns often have a low birth weight, associated obstetric problems and fall soon after birth by a sepsis with circulatory and / or respiratory insufficiency. To the late form of the infection, it usually comes when ripe, previously healthy newborn; it manifests itself with sepsis or meningitis. Diagnosis culture of blood, cervical and amniotic fluid (if any) of febrile pregnant woman culture from blood, cerebrospinal fluid, gastric fluid, meconium and infected tissues of sick newborn blood and cervical secretions should be examined in all pregnant women with an unexplained febrile infection of L. monocytogenes. A sick child born to a mother is ill with listeriosis should be investigated for sepsis back. In addition, cultures from the umbilical cord, peripheral blood, cerebrospinal fluid, gastric fluid, meconium, through any potential infected tissue, maternal lochia, the cervical and vaginal secretions, the infected placenta and amniotic liquid shares Ender mother should be created, if any. An examination of the cerebrospinal fluid may show a predominance of mononuclear cells, but usually outweigh polymorphonuclear cells. Gram Colored smears are often negative, but can pleomorphic, gram have variable coccoid structures that can not be misconstrued as diphtheroid contamination. A laboratory detection of the pathogen includes biochemical tests and observation of motility via a slide test, the darstelt motility in semisolid media. To perform the slide test, the colonies of the organism grown on solid media, mixed with saline and examined under the microscope. L. monocytogenes show a pronounced end-over-end “wobbling” movement due to the presence of flagella on both ends. Serological tests are not helpful in diagnosis. A molecular detection by PCR seems sensitive and specific, but still remains a subject of research. Prognosis The mortality rate varies between 10 and 50% and is elevated in early ill newborns. Treatment ampicillin plus aminoglycoside therapy is preferably with ampicillin with additional aminoglycosides (see Table: Recommended doses of selected pareneraler antibiotics for newborns). Usually range 14 days treatment (in meningitis 21 days), but the optimal treatment duration is unknown. Other drugs treatments are ampicillin or penicillin with rifampin or sole trimethoprim / sulfamethoxazole, and meropenem. The demonstration in the form of a study has not yet been rendered. Newborns with sepsis require other therapies (sepsis in neonates: treatment). In severe infections should be taken to carefully manage drainage fluids or secretions. Prevention Pregnant women should avoid foods that are contaminated with L. monocytogenes (non-pasteurized dairy products, soft cheese, raw vegetables, ready cooked meats and salads, frozen meat spreads or smoked fish). to separate the proper handling of food, especially uncooked meat from other items during the preparation and to wash hands, utensils and cutting boards after handling uncooked foods is crucial. If an infection is diagnosed during pregnancy, treatment prior to delivery or intra-partum can be started to prevent vertical transmission to the newborn. The effectiveness of this measure, however, is not proven. Summary An infection can be acquired during birth or in utero, and the clinical manifestations within hours or days of birth appear (early onset) or be delayed up to several weeks (delayed onset). Early onset listeriosis manifests itself soon after birth as sepsis with circulatory insufficiency, respiratory failure, or both. To the late form of listeriosis, it usually comes when ripe, previously healthy newborn; it manifests itself with sepsis or meningitis. It makes sense to create cultures of L. monocytogenes in pregnant women with an unexplained febrile illness. The treatment is preferably carried out with ampicillin and aminoglycosides. Pregnant women should avoid foods that may be contaminated with L. monocytogenes

Health Life Media Team

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