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Listeria Monocytogenes Meningitis and Rhombencephalitis

&NA; Listeria monocytogenes is now the second most common cause of acute bacterial meningitis in elderly adults and remains a less frequent but important cause of meningitis in neonates and immunocompromised patients. Unlike other causes of acute bacterial meningitis, Listeria meningitis might be complicated by true encephalitis with extension of microorganisms and inflammatory cells into the brain parenchyma; the brainstem is the typical site of involvement, and the syndrome of Listeria rhombencephalitis carries considerably higher morbidity and persistent neurologic impairment than simple meningitis. We report a case of an elderly woman with a fatal case of Listeria sepsis complicated by meningitis and rhombencephalitis with autopsy examination that was limited to the brain. In addition, we discuss the commonplace contamination of the food supply by Listeria, the pathogenesis of acute Listeria infection, and some of the factors in the cell‐mediated immune response that are responsible for ultimate control of infection.