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 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.