Listeriosis in pregnancy complicated by postpartum heart block

BACKGROUND: Listeria monocytogenes is a food-borne pathogen that primarily affects pregnant women. Cardiac involvement is an uncommon complication of infection. We present a case of a gravida with Listeria bacteremia at 36 weeks of gestation. CASE: Two of a patient's blood cultures grew L monocytogenes after she experienced chills, headache, myalgia, and diarrhea. The patient was treated with antibiotics for 48 hours, and then labor was induced, resulting in a normal delivery with a healthy neonate. On day 5 postpartum, the patient developed progressive heart block, resulting in a third-degree block, which required a pacemaker. An electrocardiogram done 30 days after hospital discharge demonstrated an atrial-sensed, ventricularly paced rhythm, which indicated that the heart block had not resolved. CONCLUSION: Heart block is a rarely reported and possibly overlooked complication of listeriosis. Mothers with listerial infection should be screened for cardiac complications to avoid unexpected decompensation.