title: Listeria monocytogenes Meningitis Complicating Rotavirus Gastroenteritis in an Immunocompetent Child.
abstract: Listeria monocytogenes only occasionally causes bacterial meningitis in immunocompetent children. We report a case of L. monocytogenes meningitis associated with rotavirus gastroenteritis. The patient was a previously healthy 20-month-old girl who was admitted because of sustained fever and lethargy after suffering from gastroenteritis for 6 days. The patient's peripheral white blood cell count was 18,600/µL and the C-reactive protein level was 2.44 mg/dL. A stool sample tested positive for rotavirus antigen. A cerebrospinal fluid (CSF) sample showed pleocytosis. Cultures of the CSF and stool samples revealed the presence of L. monocytogenes. The patient was successfully treated with ampicillin and gentamicin. We speculate that translocation of enteric flora across the intestinal epithelium that had been damaged by rotavirus gastroenteritis might have caused bacteremia that disseminated into the CSF. Both listeriosis and secondary systemic infection after rotavirus gastroenteritis are rare but not unknown. Initiation of appropriate treatment as soon as possible is important for all types of bacterial meningitis. This rare but serious complication should be taken into consideration even if the patient does not have any medical history of immune-related problems.
authors.affiliation: Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.|Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Ohnishi
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kawano
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Araki
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hamahata
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Machiko
authors.initials: M
authors.lastname: Usui
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Motoko
authors.initials: M
authors.lastname: Shimoyamada
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Tamame
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Akashi
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Sato
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000821:virology; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D008584:Meningitis, Listeria / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D012400:Rotavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D014640:Vancomycin; D002443:Ceftriaxone; D000212:Acyclovir
keywords: Listeria monocytogenes; meningitis; rotavirus