Affiliations: Department of Pediatrics, Northwick Park Hospital,
Watford Road, Harrow, Middlesex. HA1 3UJ, London, UK
Note: [] Correspondence: Dr. Donald S. Urquhart, Cystic Fibrosis Research
Fellow, Great Ormond Street Hospital, London, WC1N 3JH, UK. E-mail:
donurquhart72@doctors.org.uk
Abstract: Whilst Listeria monocytogenes (L. monocytogenes) meningitis is more
common in neonates and the immunosuppressed, consideration of listeriosis is
also warranted in otherwise healthy children. We present a case of L.
monocytogenes meningitis in an immunocompetent 6-year-old girl. She presented
with fever, irritability, pain on neck flexion and signs of a left-sided
hemiplegia. Cerebrospinal fluid analysis showed hypoglycorrhachia and raised
protein, as well as a pleocytosis with lymphocyte predominance. Standard
empirical therapy for meningitis, utilising a third-generation cephalosporin
with or without vancomycin would fail to cover L. monocytogenes. Therefore, in
cases of meningitis where focal neurological signs are present, consideration
should be given to the use of ampicillin or meropenem as part of first-line
therapy.
