A 70-year-old man was hospitalized in the hematology unit, showing symptoms of fever (temperature 38℃) and night sweats. The patient, who was treated for acute myeloid leukemia and with his last chemotherapy having been 6 weeks ago, had pancytopenia (a WBC count of 400/mm3 with 20% PMNs). On day 3 of hospitalization, L. monocytogenes was cultured in blood samples. The therapy began with ampicillin (8g/d) and amikacin (1g/d). On day 9, his condition continued to detoriate. He developed orofaringeal candidiasis and laboratory findings revealed deep neutropenia (a WBC count of 100/mm3). Antibiotic therapy was continued and I.V. amphotericin B (1mg/kg/d) was added. Despite these therapies, he died on the 13th day of hospitalization.
A 36-year-old man with epistaxis, dyspnea, headaches, sore throat, fever (temperature 39.8℃), meningeal signs and lethargy was admitted to the infectious diseases unit. One month before admission, he had undergone a renal transplantation due to amiloidosis. At the time of admission, he received prednisolone, cyclosporine and ranitidine. Examination of CSF revealed pleocytosis with a predominance of PMNs. The CSF culture yielded serotype 4 of the L. monocytogenes. Despite treatment with ampicillin (12g/d) and netilmicin (300mg/d), the patient's condition detoriated rapidly, and he died after four days of therapy.