DDSEP® 8 Quick Quiz

June 2015 Quiz 2

Publish date: May 20, 2015

A 28-year-old woman in her third trimester of pregnancy presents to the clinic with fever, chills, diarrhea, and back pain for the past 24 hours. She also notes nausea without vomiting and a mild headache. Her pregnancy has otherwise been uncomplicated. On exam, she is febrile, with no costovertebral tenderness or meningeal features, and minimal abdominal tenderness. Urine dipstick is negative, and urine gram stain is negative.


 

References

Q2: ANSWER: A

Critique

This pregnant patient has features compatible with Listeria monocytogenes infection. In any pregnant patient presenting with fever, Listeria needs to be considered after ruling out common conditions such as a urinary tract infection given the high morbidity associated with this condition. Blood cultures are used to make the diagnosis of Listeria, while stool and vaginal cultures are not helpful. While CSF cultures can be used in cases of Listeria meningitis, the yield of blood cultures is higher. Urine cultures are unlikely to add additional information in this patient’s case given the negative urine dipstick.

Reference

1. Jackson, K.A., Iwamoto, M., Swerdlow, D. Pregnancy-associated listeriosis. Epidemiol. Infect. 2010;138:1503-9.

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June 2015 Quiz 1