Two patients are admitted with the same diagnosis in the summertime, the bug shown above. A third trimester pregnant woman presents with flu-like symptoms, fever, chills, and back pain. Urinalysis is negative. The blood culture grows out the bacteria shown above. Unfortunately, her newborn is greatly affected by the transplacental infection and develops disseminated abscesses in the liver, spleen, lungs, kidney, and brains as well as papular and ulcerative skin lesions.An 80 year old man develops a subacute course of fever and confusion. There is no nuchal rigidity. A lumber puncture shows a pleocytosis and >25% lymphocytes. CSF protein is moderately elevated to 170 and glucose was mildly decreased. The gram stain is shown above.
Challenge: What organism is shown above?
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Two for One
Listeria monocytogenes primarily infects neonates, immunosuppressed patients, elderly adults, and pregnant women. Though the infection in a pregnant woman is mild, the infant can develop granulomatosis infantiseptica, described here. In the second patient, pleocytosis can be PMNs or monocytes or lymphocytes (one of the few nontuberculous infections that do this). The gram stain shows inflammatory cells and small gram-positive rods.
Source: UpToDate; image originally from Harriet Provine.
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