Listeria in Mom

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This message is from PedTalk! To reply to the group, use "" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ What would the providers do in this situation:

An almost-mom spikes a fever a few hours before delivery and receives IV ampicillin. She winds up having Listeria sepsis and is treated with ampicillin for several days after delivery. The baby shows no symptoms, serial CBC's are normal, and a couple of blood cultures are normal. Various neonatology and infectious disease consultants are mixed on whether the baby should be treated. The parents preferred not to treat, the baby was not treated, and was discharged with mom five days after delivery.

This is the situation for a baby who delivered at a hospital where I don't have admitting privileges (so I wasn't involved in the hospital care), but the baby is scheduled to see me in the office tomorrow. I'll be receiving copies of all the lab work. My questions are:

1) Any comments on the hospital management (you all know now as much about the baby as I do. I do not believe urine or CSF was examined). Would any of you have treated with antibiotics?

2) What kind of follow-up would you do, assuming the baby remains clinically well?
How often would you see the baby, and what about additional CBC's or Blood Cultures.

Thanks so much for any input.

Michael Sachs, M.D.
General Pediatrician