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 57-year-old man with a history of chronic lymphocytic leukemia and hepatic cirrhosis with a positive serology for the hepatitis C virus was brought to the hospital with a fever (temperature 38.5℃), chills, night sweats, headaches, cough and anorexia. He was empirically treated with I.V. ampicillin/sulbactam (6g/d) and amikacine (1g/d). Two separate blood specimen cultures, drawn over 72 hours, yielded serotype 4 L. monocytogenes. The antibiotic therapy continued for 14 days. The patient's condition gradually improved with antibiotic therapy. When discharged, he was advised to take oral ampicillin/sulbactam (1,5g/d) for an additional 5 days.