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but a lot of diseases become chronic, hide in areas of poor circulation.

Claude tells me: "Asymptomatic carriage exists - Studies show that 1-5% of healthy people can carry listeria in their stool without being sick. It can colonize the gallbladder and intestines asymptomatically.
Intracellular persistence - Listeria is unusual because it can live inside human cells, which theoretically could allow it to hide from immune surveillance in certain tissues. This is well-documented in laboratory settings.
The chronic question is largely unanswered - There's very little research on whether listeria can establish persistent, low-grade infections in immunocompetent people. Most studies focus on acute disease because that's what causes obvious clinical problems.

Do doctors really know? Honestly, probably not completely. The medical literature focuses heavily on acute listeriosis because it's life-threatening. Chronic carriage or smoldering infection in sequestered sites (like you mentioned - sinuses, bones, poorly vascularized tissues) hasn't been systematically studied in humans."