II. Pathophysiology

  1. Gram Positive bacillus

III. Causes: Sources

  1. Foodbourne Illness
    1. Deli Meat
    2. Frozen Vegetables (2016 outbreak in U.S.)
    3. Unpasteurized milk (including derived soft cheese)
      1. (2008) MMWR Morb Mortal Wkly Rep 57(40):1097-100 +PMID:18846031 [PubMed]

IV. Risk Factors: Severe, invasive disease

  1. Immunocompromised patients
  2. Pregnancy
  3. Newborns (may cause Neonatal Sepsis)
  4. Elderly

V. Symptoms

  1. Onset
    1. Gastrointestinal symptoms start within 9 to 48 hours
    2. Immunompetent hosts typically have self-limited course
    3. Invasive disease onset delayed for 2 to 6 weeks
  2. Gastrointestinal infection
    1. Fever
    2. Diarrhea
    3. Nausea
    4. Myalgias
  3. Invasive infection (esp. Immunocompromised patients)
    1. Bacteremia
    2. Meningitis
    3. Endocarditis
  4. Pregnancy (presents with flu-like illness)
    1. Premature delivery
    2. Stillbirth

VI. Labs

  1. Missed on Stool Culture

VII. Management

  1. See Acute Diarrhea
  2. Antibiotics
    1. Not typically used (self-limited disease in normal hosts)
    2. Consider in severe, invasive cases or high risk patients (5 days Amoxicillin or Septra has been used)

VIII. Resources

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