Listeria monocytogenes infection in patients with Inflammatory Bowel Disease: Is there an increased risk with immunomodulators or biologic agents?

Listeria monocytogenes is generally thought of as a foodborne pathogen that causes bacteremia and meningoencephalitis in individuals with impaired cell-mediated immunity, including neonates, pregnant women, elderly persons and immunosupressed recipients of transplants.1,2 Although antecedent diarrhea has been reported in cases of invasive listeriosis (i.e. a case involving the presence of L. monocytogenes in a normally sterile site), it was only recently that L. monocytogenes was established as a cause of acute, self limited, febrile gastroenteritis in healthy persons.3,4 At least 7 outbreaks of foodborne gastroenteritis for which L. monocytogenes was the most likely etiology have been described. The most commonly reported symptoms in those cases were fever, diarrhea, arthromyalgia and headache. Listeriosis can be manifested as a systemic illness associated with bacteremia, sepsis and central nervous system involvement including meningitis and encephalitis.5,6