Listeria monocytogenes meningitis

Presented is the case of a 42-year-old, previously healthy man with meningitis secondary to Listeria monocytogenes. Following lumbar puncture, empiric therapy with intravenous penicillin was started and he was hospitalized. Subsequently L monocytogenes was proven to be the causative organism and antibiotic therapy was changed to ampicillin and gentamicin. The patient's condition improved. He was discharged and continues to do well. There was no evidence at any time of underlying predisposition to infection. Listeria meningitis in healthy patients and in patients with underlying disease is discussed, along with possible implications about choice of empiric antibiotics.