LISTERIA-MENINGITIS AFTER BONE-MARROW TRANSPLANTATION

Over the past decade infections from food-borne Listeria monocytogenes have become an important cause of septicaemia and meningitis and immu nocompromised patients are at particular risk. We report three cases o f Listeria meningitis occurring post-BMT. The patients were aged 53, 5 1 and 56 years and presented 4, 7 and 90 months post-transplant, respe ctively. The first patient had undergone allogeneic BMT for myelodyspl asia and the other two patients had ABMT for AML in second and first C R, respectively. All the patients presented with classical features of meningitis and L. monocytogenes was cultured from cerebrospinal fluid . All made a full recovery with appropriate antibiotic therapy. We hav e not seen cases of meningitis due to other organisms in our transplan t programme and the cases represent a risk of one episode per 59 survi ving patient years. None of the patients was receiving prophylactic po st-BMT antibiotics and the episodes may strengthen the case for using prophylactic penicillin. Recent epidemics of septicaemia and meningiti s caused by L. monocytogenes-contaminated milk and cheese suggest that these patients should be informed about potential sources of infectio n.