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Granulomatosis infantiseptica is the severe congenital form of neonatal listeriosis, resulting from transplacental infection with Listeria monocytogenes.

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It manifests as a disseminated, often fatal septic illness in utero or at birth, characterized by sepsis, multiple granulomas/abscesses in visceral organs, and high mortality.

Etiopathogenesis

• Cause: Listeria monocytogenes (Gram-positive intracellular bacillus).

Transmission:

• Maternal bacteremia during pregnancy → transplacental spread → fetal infection.
• Less commonly, acquired during passage through birth canal (leads to late-onset listeriosis).

Pathogenesis:

• Organism invades fetal liver, spleen, lungs, skin → formation of disseminated granulomas and microabscesses with central necrosis.
• Severe septicemia develops rapidly.

![Schematic representation of the infection cycle of L. monocytogenes in humans. Following ingestion of contaminated food, the bacteria invade the intestinal barrier into the bloodstream. Through the portal circulation, the organism is transported to the liver and spleen where it multiplies before being disseminated into the bloodstream. The organism subsequently infects the brain and the placenta/fetus in pregnant women. The schematic art pieces were obtained from Servier Medical art (https://smart.servier.com (accessed on 1 March 2022)). Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License.

Sibanda T, Buys EM. Listeria monocytogenes Pathogenesis: The Role of Stress Adaptation. Microorganisms. 2022; 10(8):1522. https://doi.org/10.3390/microorganisms10081522](attachment:acf74848-81c6-40b5-a685-dec52aedaa3c:microorganisms-10-01522-g001.png)

Schematic representation of the infection cycle of L. monocytogenes in humans. Following ingestion of contaminated food, the bacteria invade the intestinal barrier into the bloodstream. Through the portal circulation, the organism is transported to the liver and spleen where it multiplies before being disseminated into the bloodstream. The organism subsequently infects the brain and the placenta/fetus in pregnant women. The schematic art pieces were obtained from Servier Medical art (https://smart.servier.com (accessed on 1 March 2022)). Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License.

Sibanda T, Buys EM. Listeria monocytogenes Pathogenesis: The Role of Stress Adaptation. Microorganisms. 2022; 10(8):1522. https://doi.org/10.3390/microorganisms10081522

Clinical Features

Early-onset disease (in utero or within 24–48 hours of birth).

• Preterm birth, stillbirth, or spontaneous abortion.
• Respiratory distress, pneumonia.
• Septicemia, hepatosplenomegaly.
• Skin lesions: multiple erythematous papules/nodules (“granulomatosis”).
• High mortality (30–50%).