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 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.