It is extremely important to consider Fusobacterium necrophorum as a cause of meningitis in children after otitis or other upper respiratory tract infections, because of its increasing incidence. A high index of suspicion and prompt microbiological identification are mandatory; as this organism is often penicillin-resistant, prolonged antibiotic therapy is required and invasive infection carries a high risk of fatal cerebral vessel thrombosis. This report presents two fatal cases who presented to our pediatric intensive care unit in December 2004.