The mode of entry in isolated cases is usually obscure, but it is generally via the gastrointestinal tract during epidemics. Gastrointestinal symptoms may or may not occur, but the bacteria promptly penetrate the intestinal mucosa and enter the blood-stream. The resulting bacteremia is usually associated with fever and muscle aches, and it is the source of meningeal infection. In pregnant women, L. monocytogenes crosses the placenta and produces widespread abscesses in tissues of the fetus. Babies infected at the time of childbirth usually develop meningitis after an incubation period of 1 to 4 weeks.
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