Syndromes:
(1) intrauterine demise
(2) early onset, including granulomatosis infantiseptica
(3) late onset
Features of intrauterine infection with fetal death:
(1) The placenta shows chorioamnionitis.
(2) Listeria may be isolated from maternal blood cultures taken during a febrile episode.
(3) The infection can result in abortion, preterm labor and stillbirth.
Features of intrauterine infection with early onset disease:
(1) The infant is ill at delivery or develops a febrile illness shortly after birth.
(2) The infant is usually septic.
(3) With granulomatosis infantiseptica the child demonstrates widespread, small granulomas or microabscesses over the skin, internal organs and placenta.
(4) Some infants may develop pneumonia and/or conjunctivitis.
(5) Cultures of the placenta, meconium, external ear, nose, throat, blood or conjunctiva may be positive for Listeria monocytogenes.
Features of late onset disease:
(1) The infant does not show signs of infection at birth and is usually healthy.
(2) There is an onset of a febrile illness 1 to 8 weeks after delivery.
(3) The infant usually presents with meningitis, but may also show a febrile gastroenteritis or pneumonia.
Late sequelae of early and late onset disease:
(1) hydrocephalus
(2) psychomotor retardation
Differential diagnosis: Group B streptococcal infection
