Challenging management of chorioamnionitis with placental listeriosis: lessons from 2 cases

Abstract

Listeriosis is a rare foodborne infection caused by Listeria monocytogenes. It is 12-20 times more prevalent in pregnant women compared to the general population, with a 20-40% mortality rate in neonates. Early treatment with appropriate antimicrobial agents is critical for pregnancy outcomes; however, the infection is difficult to control because the nonspecific clinical manifestations and rarity of the disease often preclude early diagnosis. We encountered 2 cases of pregnancy-associated listeriosis that occurred at 29 and 37 weeks of gestation. Both neonates were delivered by emergent cesarean section due to fetal condition, and one of the preterm infants died immediately after birth. Pregnancy-associated listeriosis should be considered in the management of unexplained fever or inflammatory conditions in pregnant women.

Keywords: Antimicrobials; Listeriosis; Management; Pregnancy.

Fig. 1. (A) Multiple abscess formation in the placental sections. The histological examination results show a necrotic area (B, original magnification ×12), the villus destroyed by the inflammation, and fibrinogen (C, original magnification ×200). The Brown & Brenn staining shows multiple bacilli. This confirms the presence of Listeria monocytogenes (D, original magnification ×1,000).