Listerial meningitis in infancy

Abstract

Three previously unreported cases of listerial meningitis are described. Symptoms appeared during the second week of life in two and at the age of 3 months in the third. An earlier history of maternal illness could not be elicited and bacteriological evidence of maternal infection was not found, but in the mother of the 3-month-old infant there was serological evidence of past infection from Listeria. It is suggested that this infant became infected at, or shortly before, birth and subsequently harboured the organism for three months before showing evidence of clinical infection. All three infants survived, two apparently well, the other with severe neurological sequelae. The Gram stain of the cerebrospinal fluid deposit was difficult to interpret in two of the cases since the organism decolorized easily and the characteristic tumbling motility was apparently absent in one strain possibly following a change in the pH of the liquid medium in which it had been cultured. Fifty-eight cases of listerial meningitis reported during the neonatal period were analysed regarding the day of onset of the illness. They fell into two groups; those in Group A were ill on the first day of life, while the others (Group B) developed clinical manifestations between the fourth and 28th days. The infants in Group A were thought to have been infected in utero; those in Group B at, or shortly before, birth. Among 116 cases of purulent meningitis diagnosed during the five-year period 1958-1963 in the Birmingham Children's Hospital, only four occurred during the first month of life in otherwise normal infants. Of these, two were due to Esch. coli, one to Ps. pyocyanea and one to L. monocytogenes.