We discussed a case about an elderly woman with insulin-dependent T2DM and rheumatoid arthritis (on methotrexate and hydroxychloroquine), who presented with subacute-chronic post-prandial abdominal pain, loose stools, mental status changes, found to have chronic SMA stenosis & Listeria bacteremia.

Individuals at highest risk of Listeria

  • Immunocompromised
  • Extremes of age (neonates & elderly)
  • Pregnant women

Clinical syndromes of Listeria

  • Febrile gastroenteritis
  • Invasive infections
    • Bacteremia
    • CNS infection (meningitis, encephalitis)
  • Focal infections (rarer, mostly case reports; e.g. septic arthritis, endocarditis, SSTI)


  • Antibiotics of choice: Ampicillin or Penicillin G
  • Synergistic effect: Gentamicin
    • Watch out for nephrotoxicity and ototoxicity with Gentamicin

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