Fulminant neonatal listeriosis with death within 24 hours in a preterm infant: a case report

Neonatal listeriosis, caused by Listeria monocytogenes, represents a rare yet severe infection that can result in fatal outcomes, especially among preterm infants; however, instances of mortality occurring within 24 h of diagnosis are exceedingly uncommon.

This report presents the case of a preterm female infant who developed fulminant listeriosis with rapid progression to septic shock and multiorgan failure. The patient was born at 33 5/7 weeks, weighed 2,395 g, and presented with severe respiratory distress and perinatal asphyxia. The mother had consumed refrigerated leftovers and developed fever (38.5 °C) one day prior to delivery. Upon admission, the infant exhibited metabolic acidosis (pH 7.14, lactate 10 mmol/L), leukopenia (2.7 × 10⁹/L), and septic shock. Despite immediate mechanical ventilation, inotropic support, and broad-spectrum antibiotics (penicillin and meropenem), the infant succumbed within 24 h. Blood and cerebrospinal fluid cultures confirmed Listeria monocytogenes infection.

This case emphasizes the deadly risk of neonatal listeriosis and the need for preventive measures, such as dietary precautions for pregnant women (avoiding unpasteurized dairy and properly stored leftovers) and early maternal diagnosis and treatment. Prompt recognition and antibiotic therapy for maternal listeriosis are crucial for better outcomes in this vulnerable group.