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 59-year-old man was admitted to the infectious diseases unit with a 2-day history of fever, altered mental status and headaches. He had a coronary heart disease. On admission to hospital the patient was afebrile. On day 2 of hospitalization, he developed a high fever (temperature 38.5℃) and meningeal signs. Examination of the CSF revealed a meningeal syndrome. The CSF culture yielded serotype 4 L. monocytogenes. The patient received penicillin G (24MU/d) and amikacin (1g/d) intravenously for 14-day. On day 6 of hospitalization, he became afebrile and his symptoms and findings gradually improved after administering of the therapy. The patient was diagnosed with diabetes mellitus. Antibiotic therapy continued with po ampicillin (4g/d) for 4 days, and then he was discharged.