A 62-year-old man with a history of diabetes mellitus, hepatic cirrhosis and congestive heart failure was admitted to the hospital. He was taking gliclazide, furosemide and digoxin He was admitted to the gastro-enterology unit with abdominal distention, ascites and edema on his feet. On day 12, he developed a fever, night sweats, chills, dyspnea and general malaise. His physical examination revealed a high fever (temperature 38.3℃) and tachycardia; blood and peritoneal fluid cultures were positive for serotype 4 L. monocytogenes. He underwent a course of treatment with intravenous penicillin G (24MU/d) and amikacin (1g/d) for 14 days. The patient's fever diminished after 3 days of therapy and he was discharged with a prescription of po ampicillin (4g/d) for 7 days.
A 28-year-old woman was admitted to the gynecology unit diagnosed with a recurrence of disgerminoma. Six months earlier, she had undergone total abdominal hysterectomy, bilateral salpingo-oophorectomy and cyto-reductive surgery for disgerminoma. After the surgery, she received radiotherapy and 4 sessions of chemotherapy. The last session of chemotherapy had ended 2 weeks ago. On day 4, the patient developed a fever (temperature 39.2℃), chills and sweats and was in poor condition in general. Two sets of blood cultures were positive for serotype 1 L. monocytogenes. The patient started receiving penicillin G (20MU/d). On day 6 of hospitalization, she became afebrile and her symptoms and findings progressively improved. Blood cultures that were taken within 3 days of therapy gave negative results for L. monocytogenes. She was discharged from the hospital on the 18th day and subsequently received ampicillin (4g/d) perorally for 7 days.