Bacterial meningitis in older neonates.

During a five-year period, 24 patients' conditions (age range, 2 to 6 weeks) were diagnosed, and they were treated for bacterial meningitis. Organisms recovered from the CSF included group B Streptococcus (n = 6), Escherichia coli (n = 5), Listeria monocytogenes (n = 5), Hemophilus influenzae (n = 4), Streptococcus pneumoniae (n = 2), and group D and group A Streptococcus (one each). Initial antimicrobial therapy must include antibiotics that are effective across this spectrum of potential pathogens. Symptoms and signs were often subtle. Six children (25%) experienced major neurologic residua, including five patients (21%) in whom hydrocephalus developed. Ultrasound examination of the head at the end of therapy was an effective technique for early assessment of neurologic sequelae.