Three cases of neonatal listeriosis are reported. This local incidence in a busy neonatal unit over a 10-year period would agree with other reports that the condition is rare in the United Kingdom. Two cases had septicaemia and one developed septicaemia and meningitis, contrasting with the previous view that the commonest presentation is with meningitis, and could be due to the greater use of blood cultures in babies suspected of having infection. The mode of delivery differed in each case which allowed certain conclusions to be made regarding pathogenesis of the condition. Thus evidence is presented against fetal infection through an ascending route or while passing through an infected birth canal. Maternal bacteraemia with a transplacental spread of infection would seem more likely. The possible use of Gentamicin in the treatment of this condition is discussed and the better prognosis with septicaemia, compared with meningitis, is emphasized.
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