Are oral mouth ulcers an early sign of listeriosis (infection with Listeria monocytogenes)?

From the Guidelines

Oral mouth ulcers are not typically considered an early sign of listeriosis (infection with Listeria monocytogenes). The classic early symptoms of listeriosis include fever, muscle aches, nausea, diarrhea, and sometimes headache, as noted in guidelines for preventing opportunistic infections among HIV-infected persons 1. Listeria is a foodborne bacterial infection that primarily affects the gastrointestinal system initially, before potentially spreading to the bloodstream and nervous system in severe cases. Mouth ulcers are more commonly associated with other conditions such as canker sores, viral infections like herpes simplex, vitamin deficiencies, autoimmune disorders, or as a side effect of certain medications.

Key Considerations

• The provided evidence focuses on guidelines for preventing opportunistic infections among HIV-infected persons, including listeriosis, but does not specifically mention oral mouth ulcers as an early sign of listeriosis 1.
• It is crucial to differentiate between the symptoms of listeriosis and other conditions that may cause mouth ulcers, to ensure appropriate diagnosis and treatment.
• If you have mouth ulcers along with fever, severe headache, stiff neck, confusion, or balance problems, you should seek medical attention immediately as these could indicate a more serious infection, though not necessarily listeriosis.

Diagnosis and Treatment

Listeria infection is typically diagnosed through blood or spinal fluid cultures and is treated with antibiotics such as ampicillin or penicillin, often in combination with gentamicin for 2-6 weeks depending on the severity and location of infection. Given the severity of listeriosis, especially in immunocompromised individuals, it is essential to follow preventive measures as outlined in the guidelines 1 to reduce the risk of infection.

From the Research

Symptoms of Listeriosis

• The provided studies do not specifically mention oral mouth ulcers as an early sign of listeriosis 2, 3, 4, 5, 6.
• Common symptoms of listeriosis include fever, diarrhoea, nausea, and vomiting, which can occur within 7 days of exposure to contaminated food 3.
• Invasive infection can develop in high-risk patients, characterized by bacteraemia and encephalitis 3.

High-Risk Groups

• Pregnant women, the elderly, and immunocompromised patients are at increased risk of developing listeriosis 2, 3, 4, 5, 6.
• These groups are more susceptible to severe illness and high mortality rates due to listeriosis 3, 5.

Treatment and Prevention

• Antibiotic treatment, such as penicillin-based therapy, is effective against listeriosis 2, 3, 4, 6.
• Prevention strategies include avoiding contaminated foods, such as soft ripened cheeses and unpasteurised milk, and counseling vulnerable individuals on safe food handling practices 3, 5.