METHODS: We report the case of a nursing home resident with multiple co-morbidities who presented with abdominal complaints and fever. We found diffuse tenderness on abdominal examination without guarding or rebound pain. No other neurologic symptoms were reported and neurologic evaluation showed a normal mental status, no movement disorders, no neck stiffness, and no focal neurologic deficit. Intervention (& Technique): Blood results revealed moderate inflammation, but a CT scan of the abdomen showed no abdominal focus of infection. Hemocultures became positive with Listeria monocytogenes the day after admission, indicating a diagnosis of Listeria sepsis. The patient was admitted to the hospital for intravenous rehydratation with a tentative diagnosis of viral gastroenteritis. After receipt of the positive hemocultures, treatment was initiated with aminopenicillin (amoxicillin 4 × 1 g per day) with good clinical result.
CONCLUSIONS: Listeriosis occurs more frequently in older patients than in pregnant women and still has a high mortality despite adequate treatment. Physicians, in particular geriatricians, should be aware of this potentially severe foodborne infection. In older adult consumers and long-term care facilities, recommendations for safe food handling and storage should be emphasized.