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Neonatal disseminated listeriosis

Last edited: 4/23/2026

Overview

Neonatal disseminated listeriosis refers to the widespread infection of the neonatal period caused by Listeria monocytogenes, often leading to severe complications including disseminated fibrin thromboembolism, which can contribute significantly to mortality in affected infants 1.

Diagnosis

  • Clinical Presentation: May present with nonspecific symptoms such as sepsis-like signs, respiratory distress, and organ dysfunction 1.
  • Laboratory Findings: Elevated inflammatory markers, thrombocytopenia, and potentially high plasma fibrinogen levels 1.
  • Imaging: Abnormalities may include findings suggestive of disseminated intravascular coagulation (DIC) or thrombotic events 1.
  • Histopathology: Identification of disseminated fibrin thrombi in affected organs can be diagnostic 1.
  • Culture and PCR: Blood, cerebrospinal fluid, and other sterile sites for Listeria monocytogenes 1.

    • Management

  • Antibiotics: Ampicillin and gentamicin are first-line treatments; adjust based on susceptibility patterns 1.
  • Supportive Care: Focus on hemodynamic stabilization, respiratory support, and management of organ dysfunction 1.
  • Monitoring: Close monitoring for signs of DIC and thrombotic complications, including renal and adrenal involvement 1.

    • Special Populations

  • Twins: One twin may exhibit disseminated fibrin thromboembolism while the other survives, highlighting individual variability in susceptibility 1.

    • Key Recommendations

  • Aggressive Early Diagnosis and Treatment: Initiate broad-spectrum antibiotics promptly in neonates suspected of disseminated listeriosis to improve outcomes (Evidence: Moderate 1).
  • Monitor for Disseminated Thrombotic Complications: Regularly assess for signs of disseminated fibrin thromboembolism, especially in the later neonatal period, given its high incidence and potential lethality (Evidence: Moderate 1).
  • Consider Individual Variability in Twins: In twin pregnancies, monitor both infants closely as one may be affected while the other remains unaffected (Evidence: Expert opinion 1).

    • References

    1 Boyd JF. Disseminated fibrin thromboembolism among neonates dying more than 48 hours after birth. Journal of clinical pathology 1969. link

    Original source

    1. [1]
      Disseminated fibrin thromboembolism among neonates dying more than 48 hours after birth. — Boyd JF Journal of clinical pathology (1969)
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