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February 1986

Ampicillin-Resistant Listeria monocytogenes Meningitis

Arch Neurol. 1986;43(2):106. doi:10.1001/archneur.1986.00520020004004

To the Editor.  —We read with interest the report by Rapp et al1 of the occurrence of ampicillin-resistant Listeria monocytogenes meningitis in a previously healthy 14-year-old athlete. We have recently reviewed 54 cases of proven juvenile and adult listerial infection of the central nervous system (CNS) reported to the Public Health Laboratory Service in England and Wales between 1975 and 1980.2 Of the ten patients who received ampicillin as the initial sole antibiotic, resistance to the drug was noted in two instances, but recovery followed a change to chloramphenicol. However, the latter drug, which was used as the initial therapy in five cases, also had to be changed in two instances because of resistance. Moreover, one patient, a woman aged 63 years with diabetes and pemphigus for which she was receiving gold sodium thiomalate, cosyntropin, and azathioprine, developed a fatal agranulocytosis. It has been reported3 that the