QUESTIONS RAISED BY LISTERIA-MONOCYTOGENE S MENINGITIS IN CHILDREN

Listeria monocytogenes human infections more frequently affect the new born and the old adult; some of these infections may be related to an underlying disease or be due to an immunodeficiency, The following que stions were raised by the case of a12 year old immunocompetent girl, s uffering from a L. meningitis. The physician has to face two problems: one concerns the diagnosis of listeriosis, because of its low frequen cy among pediatric meningitis, and in this case a quick bacteriologica l answer is essential; the other concerns what treatment to undertake pending bacteriological results. Indeed, therapeutic guidelines issued by consensus conferences on pediatric bacterial meningitis do not tak e listeria into consideration. Consequently, the authors suggest addin g amoxicillin to the initial treatment when listeriosis is suspected ( immunosuppressive therapy, underlying disease, meningoencephalitis).