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.
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.