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.
A 64-year-old man with fever, nausea, vomiting, diarrhea and altered mental status was admitted to the infectious diseases unit. On physical examination, he had lethargy and acutely ill with a high fever (temperature 38℃), tachycardia and meningeal signs. The analysis of the CSF revealed a meningeal syndrome with increased levels of protein, pleocytosis with a predominance of PMNs. He had a history of chronic obstructive pulmonary disease. The CSF culture yielded serotype 4 L. monocytogenes. Two sets of blood cultures came out negative. He was treated with penicillin G (24MU/d for 14 days), and his condition transiently improved after administering the antibiotic treatment. The patient became afebrile and was discharged with a prescription for po ampicillin (4g/d) to complete a 21-day course of antibiotic therapy.