Question

A woman presents with leakage of fluid per vaginum and meconium stained liquor at 34 weeks of gestation. The most likely organism causing infection would be:

• A. Listeria monocytogenes
• B. Toxoplasmosis
• C. CMV
• D. Herpes

Hint:

Early meconium-stained liquor with membrane rupture is the classic Listeria clue.

Answer 1

The Correct Option is A

Step 1: The clinical picture is preterm rupture of membranes (leakage of fluid) at 34 weeks with meconium-stained liquor. Meconium passage at this early gestation is unusual and is a recognised clue to intrauterine Listeria infection.
Step 2: Listeria monocytogenes is acquired from contaminated food (unpasteurised dairy, deli meats). In pregnancy it crosses the placenta and causes chorioamnionitis, preterm labour, and the characteristic early meconium staining of the liquor.
Step 3: Meconium-stained liquor before term is the classic examination flag for Listeria, distinguishing it from the other listed organisms.
Step 4: Toxoplasma and CMV cause congenital infection syndromes (calcification, chorioretinitis, growth restriction) rather than acute meconium-stained PROM. Herpes causes neonatal skin, eye and CNS disease, typically through birth-canal exposure, not this picture.
Step 5: The organism best fitting preterm membrane rupture with meconium-stained liquor is Listeria monocytogenes.
Hence the answer is Listeria monocytogenes, option A.