Listeriosis in pregnancy complicated by postpartum heart block.
BACKGROUND
Listeria monocytogenes is a food-borne pathogen that primarily affects pregnant women. Cardiac involvement is an uncommon complication of infection. We present a case of a gravida with Listeria bacteremia at 36 weeks of gestation.


METHODS
Two of a patient's blood cultures grew L monocytogenes after she experienced chills, headache, myalgia, and diarrhea. The patient was treated with antibiotics for 48 hours, and then labor was induced, resulting in a normal delivery with a healthy neonate. On day 5 postpartum, the patient developed progressive heart block, resulting in a third-degree block, which required a pacemaker. An electrocardiogram done 30 days after hospital discharge demonstrated an atrial-sensed, ventricularly paced rhythm, which indicated that the heart block had not resolved.


CONCLUSIONS
Heart block is a rarely reported and possibly overlooked complication of listeriosis. Mothers with listerial infection should be screened for cardiac complications to avoid unexpected decompensation.
Agulnik
Asya L
AL
From the Stanford University Medical School, Stanford University, Stanford; Lane Medical Library, Stanford University, Stanford; and Department of Obstetrics and Gynecology, Santa Clara Valley Medical Center, San Jose, California.
Maggio
Lauren
L
Wong
Luchin F
LF
Dwyer
Bonnie K
BK
D000328:Adult; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D008088:Listeriosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011644:Puerperal Disorders / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy