Early-Onset Neonatal Listeriosis Presenting With Fulminant Sepsis and Grade III Intraventricular Hemorrhage in an Extremely Preterm Neonate

Early-onset neonatal listeriosis is a rare but severe infection caused by vertical transmission of Listeria monocytogenes from mother to fetus. We report an extremely preterm female neonate born at 28 weeks and 5 days of gestation, weighing 1.15 kg, to a mother with preterm premature rupture of membranes, meconium-stained liquor, and decreased fetal movements. Soon after birth, the infant developed severe respiratory distress requiring mechanical ventilation. Laboratory evaluation revealed sepsis with elevated inflammatory markers, thrombocytopenia, and cerebrospinal fluid findings suggestive of bacterial meningitis. Blood culture from the neonate grew L. monocytogenes. Maternal endometrial and high vaginal swabs also grew the same organism, supporting vertical transmission. Cranial ultrasonography demonstrated bilateral germinal matrix hemorrhage with grade III intraventricular hemorrhage. Placental histopathology showed chorioamnionitis and funisitis. The neonate was treated with intravenous ampicillin for 21 days and recovered well. This case highlights the importance of early microbiological diagnosis and prompt targeted therapy in neonatal listeriosis.