Listeriosis in pregnancy: under-diagnosis despite over-treatment

Objective:to compare the symptomatology of pregnant women with suspected listeriosis to culture confirmed listeriosis.study design:all cases of suspected and culture confirmed pregnancy-associated listeriosis from a single center were retrospectively reviewed assessing demographics, clinical, laboratory and pathological findings, and maternal, fetal and neonatal outcomes.results:listeriosis was identified in seven patients, none of whom belonged to the 117 women with suspected listeriosis. women with confirmed infection were more likely to exhibit fever (p=0.01), flu-like symptoms (p=0.006), threatened preterm labor (p=0.05) and inflammatory markers (p=0.02), but less likely to exhibit gastrointestinal complaints (p=0.004) in comparison with suspected non-confirmed cases. confirmed cases resulted in preterm delivery (n=5) and stillbirth (n=2). neonatal complications included meningitis, respiratory disease and sepsis. maternal outcomes were favorable.conclusion:although ‘febrile gastroenteritis’ is a poor predictor of listeriosis in pregnancy, fever, premature contractions and inflammatory markers are important risk indices prompting workup and adequate empiric treatment.