Question:medium

A 6-week-old infant presents with bacterial meningitis. Which organism is the most likely cause?

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Which organism makes us add ampicillin to empirical therapy in this age band?
Updated On: Jun 25, 2026
  • Staphylococcus aureus
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Listeria monocytogenes
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The Correct Option is D

Solution and Explanation

The cause of meningitis is strongly age-dependent. In the first weeks of life the offending bacteria come mainly from the mother's vaginal and gastrointestinal flora, giving the well-known trio of Group B $Streptococcus$, $E.\ coli$ and $Listeria\ monocytogenes$.

A $6$-week-old still falls within this early-infancy pattern. Of the four answer choices, only $Listeria$ belongs to that maternal-flora group, making it the best response. $S.\ pneumoniae$ and $H.\ influenzae$ dominate later in infancy and childhood once passive maternal immunity declines, and $S.\ aureus$ is tied to surgery, trauma, or indwelling devices rather than spontaneous infant meningitis.

This is also why guidelines pair ampicillin with a third-generation cephalosporin in this age group: the cephalosporin alone misses $Listeria$.

\[\boxed{\text{Listeria monocytogenes}}\]
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