Clinical Analysis of 14 Pediatric Cases of Listeria Monocytogenes Meningitis in Southwest China

Abstract

Background: Pediatric meningitis caused by Listeria monocytogenes is rare and is associated with high mortality and morbidity. Because L. monocytogenes meningitis in children from Southwest China has rarely been reported, we aimed to summarize the clinical data of pediatric L. monocytogenes meningitis cases encountered at our hospital to improve disease diagnosis and treatment. Methods: Predisposing factors, clinical manifestations, laboratory tests, and cranial images of 14 pediatric patients were retrospectively analyzed. Results: Among the patients, 57% were neonates (87.5%, preterm infants; 50%, maternofetal infection cases). In non-neonatal cases, 50% had predisposing factors, including cancer-associated chemotherapy and congenital heart disease with rickets. All neonatal cases had positive blood cultures, with poor response, frequent apnea or tachypnea, birth asphyxia, and seizure being the predominant manifestations. All non-neonates had positive cerebrospinal fluid (CSF) cultures, with fever, vomiting, headache, and neck stiffness being the predominant symptoms. Pediatric patient mortality was 21.4% (two neonates with maternofetal infection; one non-neonate). Excluding three deaths and one self-discharge, three patients had hydrocephalus (two neonates; one non-neonate); four patients had developmental retardation (three neonates; one non-neonate). Conclusions: L. monocytogenes meningitis had numerous predisposing factors, commonly including mother-tochild transmission in neonates (particularly preterm infants) and hypoimmunity in non-neonates. Differently aged patients showed different clinical manifestations. Neonatal and non-neonatal cases, mostly occurred secondary to bloodstream infections and CSF infections, respectively. Mortality rate was high, and hydrocephalus was the predominant neurological complication. Mortality and disability rates were higher for neonates than for nonneonates.