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Listeria Dietary Advice Immunosuppression — SCE Infectious Diseases MCQ

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EasyImmunocompromised HostListeria Dietary Advice ImmunosuppressionSCE Infectious Diseases

A 60-year-old woman with ANCA vasculitis on Rituximab and Prednisolone develops a fever. Blood cultures grow Listeria monocytogenes. She has been eating soft cheeses and smoked salmon. What dietary advice should have been given when starting immunosuppression?

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Correct answer: D — Avoid high-risk foods: unpasteurised dairy, soft mould-ripened cheeses (Brie, Camembert), pâté, smoked fish, and ready-to-eat cold meats — Listeria prevention is a key component of immunosuppression counselling

Listeria monocytogenes causes severe invasive infection (meningitis, bacteraemia) in immunosuppressed patients. It is acquired through contaminated food: unpasteurised dairy, soft cheeses, pâté, smoked fish, pre-prepared salads, and ready-to-eat cold meats. ALL patients starting significant immunosuppression (Rituximab, anti-TNF, transplant recipients, high-dose steroids) should receive dietary advice about Listeria avoidance — analogous to pregnancy dietary advice. This is a frequently omitted counselling point.

Reference: UKHSA 2024 – Listeriosis; BSR 2024 – Immunosuppression safety; NICE CKS