Meningitis de etiología poco habitual en ni？os

meningitis caused by listeria monocytogenes is an uncommon disease in children and even more uncommon in immuno-competent patients. we report a previously healthy 4-years old patient, who was admitted with a diagnosis of meningeal syndrome with an abnormal spinal fluid. he was initially treated with cefotaxime and dexametasone, but, as fever persisted after 48 hours, vancomycin and acyclovir were added to the previous therapy. after 72 hours, the report of the spinal fluid was received showing gram-positive rods. the culture grew listeria monocytogenes, and therapy with ampicillin was initiated; previously prescribed antibiotic agents were withdrawn. complications included an epileptic status caused by hyponatremia with normal plasma osmolarity; after 20 days the patient suffered an acute hydrocephalia which required a ventriculo-peritoneal shunt. we emphasize in the importance of spinal fluid gram stain in order to orientate the empirical initial therapy, and the hydroelectrolytical balance in order to decrease the morbidity and mortality of this severe disease.