AUTHOR=Mo Tingting , Wu Fang , Dou Xiangjun , Wang Dong , Xia Han , Li Xia 

TITLE=A Retrospective Study of Rare Listeria Meningoencephalitis in Immunocompetent Children in China

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.827145

DOI=10.3389/fneur.2022.827145

ISSN=1664-2295

ABSTRACT=Objectives: Listeria meningoencephalitis (LMM) is very rare in healthy children. We aimed to assess the clinical features, differential diagnosis, treatment options and outcomes of LMM in immunocompetent children.
Methods: The clinical symptoms, laboratory findings, imaging features, antibiotic use and metagenomic next-generation sequencing (mNGS) results of the cerebrospinal fluid (CSF) were obtained from immunocompetent children who were diagnosed with LMM and admitted to the Xi’an Children’s Hospital from May 2018 to July 2020. 
Results: The data from 8 immunocompetent children were retrospectively analyzed in this study. The cohort included data from 5 males and 3 females who were aged from 1 year and 7 months to 16 years and 6 months. 4 patients had chilled food before onset. The complications included hyponatremia (3/8), hydrocephalus (2/8) and hemophagocytic syndrome (1/8). 8 patients were diagnosed as LMM by positive culture or mNGS results. The positive rate of CSF culture was 62.5% (5/8). 5 patients conducted CSF mNGS, the results of mNGS were positive in 4 patients, suspected in 1 patient. 7 patients changed therapeutic regimen to combined antibacterial therapies that included linezolid and meropenem (5/8), ampicillin and meropenem (2/8). 5 patients had favorable outcomes (GOSE=5) whilst 2 patients had unfavorable outcomes (GOSE=1) and were complicated with hyponatremia and hydrocephalus.
Conclusions: LMM can occur in children with normal immune function and is commonly mistaken for other central nervous system infections. L. monocytogenes can be quickly and accurately detected by mNGS. Hyponatremia, hydrocephalus may indicate unfavorable outcomes. 
Keywords: Listeria monocytogenes, meningoencephalitis, children, immunocompetent, next-generation sequencing.