title: [Infections by Listeria monocytogenes].
abstract: BACKGROUND
  Listeria monocytogenes infections have been poorly characterized in Chile.
  
  
  OBJECTIVE
  To evaluate clinical manifestations and risk factors associated to a fatal outcome in a series of patients.
  
  
  METHODS
  retrospective analysis of cases from 1991 to 2012.
  
  
  RESULTS
  Twenty three cases were identified, including 2 diagnosed after prolonged hospitalization (8.7%) with an average age of 68.4 years (range 44-90). Known predisposing factors were age > 65 years (60.9%), diabetes mellitus (40.9%), and immunosuppression (27.3%). Most cases presented after 2003 (70%). No cases associated with neonates, pregnancy or HIV infections were recorded. Patients presented with central nervous system (CNS) infection (39%), including 8 cases of meningitis and one of rhomboencephalitis; bacteremia (43.5%), including one case with endocarditis; abscesses (8.7%); and other infections (spontaneous bacterial peritonitis and pneumonia; 8.7%). Risky food consumption was found in 80% of those asked about it. Predominant clinical manifestations were fever (90.9%), and confusion (63.6%). CNS infections were associated to headache (OR 21, p < 0.05), nausea and vomiting (OR 50, p < 0.01). Only 45.5% received initial appropriate empirical therapy and 36.4% a synergistic combination. Eight patients died (34.8%), this outcome was associated to bacteremia (OR 8.25; IC95 1.2-59 p < 0.05).
  
  
  CONCLUSIONS
  L. monocytogenes infections appear to be increasing in Chile, causing infections in different sites, attacking vulnerable patients, and have a high case-fatality ratio, especially among those with bacteremia.
authors.affiliation: Departamento de Medicina, Hospital Militar de Santiago, Santiago, Chile.
authors.forename: Rocío
authors.initials: R
authors.lastname: Sedano
authors.forename: Alberto
authors.initials: A
authors.lastname: Fica
authors.forename: Dannette
authors.initials: D
authors.lastname: Guiñez
authors.forename: Stephanie
authors.initials: S
authors.lastname: Braun
authors.forename: Lorena
authors.initials: L
authors.lastname: Porte
authors.forename: Jeannette
authors.initials: J
authors.lastname: Dabanch
authors.forename: Thomas
authors.initials: T
authors.lastname: Weitzel
authors.forename: Andrés
authors.initials: A
authors.lastname: Soto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008089:Listeria monocytogenes; D008088:Listeriosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons