From the Research
No, an asymptomatic pregnant woman who suspects she ate listeria-infected salmon should not receive presumptive empiric antibiotic treatment. Instead, she should be monitored for symptoms of listeriosis, which include fever, muscle aches, nausea, vomiting, and diarrhea. The standard approach is watchful waiting rather than preemptive antibiotics because the risk of infection from a single exposure is relatively low, and unnecessary antibiotic use carries its own risks including side effects, allergic reactions, and antimicrobial resistance. If symptoms develop, the woman should seek immediate medical attention, at which point blood cultures would be obtained and appropriate antibiotic therapy (typically intravenous ampicillin, sometimes with gentamicin) would be initiated, as recommended by the most recent study 1. Listeria monocytogenes can cross the placental barrier and cause serious complications including miscarriage, stillbirth, preterm labor, or neonatal infection, which is why prompt treatment of symptomatic infection is crucial. However, treating asymptomatic exposure is not recommended as the vast majority of exposures do not result in clinical infection.
Some key points to consider:
- The incidence of listeriosis associated with pregnancy is approximately 13 times higher than in the general population, as noted in 2.
- Maternal infection may present as a nonspecific, flu-like illness with fever, myalgia, backache, and headache, often preceded by diarrhea or other gastrointestinal symptoms, as described in 2.
- The necessary dietary guidance for pregnant women can reduce the incidence rate of pregnancy-related listeriosis, as mentioned in 1.
- Listeriosis can be diagnosed using positive cultures from maternal or neonatal blood, neonatal cerebrospinal fluid (CSF), amniotic fluid, intrauterine mucosa, or the placenta, as stated in 1.
- Two weeks of high-dose intravenous amoxicillin (more than 6 g/day) is recommended for LM pregnant women without allergy, according to 1.
It is essential to prioritize the health and safety of both the mother and the fetus, and watchful waiting is the recommended approach for asymptomatic pregnant women who suspect they ate listeria-infected salmon, as supported by the evidence from 2, 1.