A 30-week neonate born to a mother with fever and flu-like illness during labor develops respiratory distress and granulomatous skin lesions. Blood culture grows gram-positive rods. Which organism is the most likely cause?

• A Staphylococcus aureus
• B Group B Streptococcus
• C Escherichia coli
• D Listeria monocytogenes ✓

Explanation

Listeria monocytogenes is a gram-positive rod that causes early-onset neonatal sepsis, often acquired transplacentally or during delivery. It is classically associated with disseminated granulomatous skin lesions known as granuloma infantiseptica. Group B Streptococcus and Staphylococcus aureus are gram-positive cocci, while Escherichia coli is a gram-negative rod. Therefore, the presence of gram-positive rods with granulomas strongly points to Listeria.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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