Listériose au cours de la grossesse

Listeriosis is a rare food-born disease which affects primarily pregnant women and subjects with major medical conditions. Listeria monocytogenes is found in about 10% of food samples, particularly in sausages, raw meat, soft cheese and smoked fishes. The incidence of listeriosis have been dramatically reduced over the past decade, following prevention measures in food industry. Currently, the annual incidence is about 4 cases per million, including 20 to 25% of cases associated with pregnancy. About two thirds of perinatal cases are diagnosed in the third trimester. The most frequent maternal symptoms are fever, flu-like syndrome and preterm labor. Meningoencephalitis is rare during pregnancy. In contrast, the overall fetal and neonatal mortality rate is of 25% in recent studies. Therefore, listeriosis should be evoked in any case of unexplained fever during pregnancy. This requires blood cultures and immediate antibiotic therapy with amoxicillin for 10 days. The treatment of choice in case of documented listeriosis is high dose amoxicillin for 3 weeks plus gentamicin for 2 weeks.