Listeria monocytogenes sepsis in the nursing home community: a case report and short review of the literature.

Objective and importance Listeria monocytogenes is a rare foodborne pathogen, causing both outbreaks and sporadic infections. Severe, systemic infections are more prevalent in at-risk populations, such as pregnant women, but occur mostly in older people and immunocompromised individuals. In this case report, we describe the presentation, diagnosis, and treatment of Listeria monocytogenes sepsis in an older patient, and we briefly review the literature about listeriosis and the importance of safe food practices. Clinical presentation We report the case of a nursing home resident with multiple co-morbidities who presented with abdominal complaints and fever. We found diffuse tenderness on abdominal examination without guarding or rebound pain. No other neurologic symptoms were reported and neurologic evaluation showed a normal mental status, no movement disorders, no neck stiffness, and no focal neurologic deficit. Intervention (& Technique) Blood results revealed moderate inflammation, but a CT scan of the abdomen showed no abdominal focus of infection. Hemocultures became positive with Listeria monocytogenes the day after admission, indicating a diagnosis of Listeria sepsis. The patient was admitted to the hospital for intravenous rehydratation with a tentative diagnosis of viral gastroenteritis. After receipt of the positive hemocultures, treatment was initiated with aminopenicillin (amoxicillin 4 × 1 g per day) with good clinical result. Conclusion Listeriosis occurs more frequently in older patients than in pregnant women and still has a high mortality despite adequate treatment. Physicians, in particular geriatricians, should be aware of this potentially severe foodborne infection. In older adult consumers and long-term care facilities, recommendations for safe food handling and storage should be emphasized.