Biliary atresia associated with prenatal infection by Listeria monocytogenes.

atresia associated with prenatal infection by Listeria monocytogenes. Recent disorganization of extrahepatic bile ducts was shown in a premature infant dying at 3 hours of age of an intrauterine pneumonia associated with an amniotic infection by Listeria monocytogenes. The alimentary canal was heavily infected with Listeria and listerial abscesses were located in the periportal zones of the liver. An ascending listerial cholangitis was considered to have caused both the abscesses and the disruptive changes in the biliary tract. Heavy infection of the alimentary tract from the amniotic cavity is usual in prenatal listeriosis, and the infection may resolve postnatally without severe systemic involvement. Listeria monocytogenes should be added to the list of prenatal infections which might cause 'idiopathic' biliary atresia. Prenatal infection by the Gram-positive bacillus, Listeria monocytogenes, is an established cause of perinatal morbidity and mortality with a worldwide is known of the usual sources and portals of entry of the maternal infection, the route by which this infection is transmitted to the fetus, and the reasons for the particular susceptibility of the conceptus. In 1969, 13 cases of neonatal listeriosis were diagnosed within 3 months at the National Women's Hospital in Auckland where the disease was rare previously: 7 infants died. The clinical and pathological features of this epidemic have been described previously (Becroft et al., 1971) but the unusual changes found in the biliary tract of one infant have implications which will be considered in more detail in this report. Case Report A female Maori infant aged 2 hours was admitted to hospital because of episodes of apnoea associated with prematurity. The 18-year-old mother had had two previous pregnancies. The first child had been delivered at term, but died aged 3 hours, and pulmonary atelec-tasis was the only abnormality recorded at necropsy. The second pregnancy aborted at 12 weeks' gestation. The mother had been well during the third pregnancy.