•אם ללא חום וללא הצדקה קלינית לאשפוז – טיפול תומך בלבד.
•כאשר יש חום מעל 38 – טיפול אמפירי לכיסוי ליסטריה: IV Ampicillin 2g x 6/day • עד חזרת תרביות.
•אם שלשול פרפוזי להוסיף: PO Azithromycin 500mg x 1/day for three days
•יש לקחת תרביות דם ותרבית צואה רגילה במקרי אשפוז.
מתוך UPTODATE - ליסטריה
Author:
Febrile gastroenteritis — The need for treatment of listerial febrile gastroenteritis depends upon the host as follows:
●Among immunocompetent patients with listerial febrile gastroenteritis, the illness has resolved in the majority of patients (typical duration ≤2 days) by the time the organism is identified [25]. We therefore suggest that immunocompetent patients with isolated listerial febrile gastroenteritis not receive antimicrobial therapy.
●Invasive infection such as meningitis, meningoencephalitis, or bacteremia seems to be rare, with the risk being greatest in immunocompromised, pregnant, and older adult patients [26]. In pregnant women, listerial febrile gastroenteritis can lead to fetal death, premature birth, or infected newborns [27-30]. We suggest that oral ampicillin or trimethoprim-sulfamethoxazole be given for several days in immunocompromised, pregnant, or older adult patients with listerial febrile gastroenteritis, particularly if they are still symptomatic or have ingested a food implicated in an outbreak [25].
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