# Acute Respiratory Distress Syndrome Associated With Listeria monocytogenes in a Pregnant Woman: Case Report and Systematic Review

## TL;DR

This paper reports a rare case of respiratory failure in a pregnant woman caused by a Listeria infection and reviews similar cases in the literature.

## Contribution

The study provides the fourth documented case of ARDS due to gestational listeriosis and emphasizes the need for early diagnosis and treatment.

## Key findings

- Four cases of ARDS associated with gestational listeriosis were identified, with favorable maternal outcomes in all but one fetal death.
- Common symptoms included fever, tachypnea, and laboratory findings like lymphopenia and thrombocytopenia.
- Noninvasive oxygenation and ampicillin therapy were highlighted as potential treatment strategies to avoid intubation.

## Abstract

The purpose of the study is to describe the clinical presentation of pregnant women diagnosed with acute respiratory distress syndrome (ARDS) secondary to Listeria monocytogenes infection, complemented by a systematic review of reported cases in the literature.

A systematic review was conducted in accordance with PRISMA guidelines using major international databases (PubMed, Scopus, Web of Science, Embase, and SciELO) and gray literature sources. Included studies comprised case reports of ARDS associated with microbiologically confirmed gestational listeriosis. Data extraction focused on clinical, laboratory, and imaging variables, as well as maternal–fetal outcomes.

A total of three prior cases of ARDS associated with gestational listeriosis were identified in the literature. Including the present report, four cases were analyzed, with a mean maternal age of 26 years. Three patients were in the third trimester and one in the second trimester. The duration of illness ranged from 3 to 6 days, with all patients presenting with fever and tachypnea; additional symptoms included abdominal pain, nausea, vomiting, chest pain, and dyspnea. Laboratory abnormalities included lymphopenia (244–393 cells/mm3) and thrombocytopenia (56,000–68,000/mm3) in two patients. Three required intensive care monitoring, and two underwent mechanical ventilation. Maternal outcomes were favorable in all cases; however, one fetal death was reported.

ARDS associated with listeriosis during pregnancy is an exceptionally rare but high‐risk condition that necessitates early diagnosis and timely intensive care. This study highlights the importance of prompt clinical recognition, appropriate antibiotic therapy with ampicillin, and the potential role of noninvasive oxygenation strategies to avoid intubation in pregnant patients with acute respiratory failure.