A 28-year-old woman was admitted to the gynecology unit diagnosed with a recurrence of disgerminoma. Six months earlier, she had undergone total abdominal hysterectomy, bilateral salpingo-oophorectomy and cyto-reductive surgery for disgerminoma. After the surgery, she received radiotherapy and 4 sessions of chemotherapy. The last session of chemotherapy had ended 2 weeks ago. On day 4, the patient developed a fever (temperature 39.2℃), chills and sweats and was in poor condition in general. Two sets of blood cultures were positive for serotype 1 L. monocytogenes. The patient started receiving penicillin G (20MU/d). On day 6 of hospitalization, she became afebrile and her symptoms and findings progressively improved. Blood cultures that were taken within 3 days of therapy gave negative results for L. monocytogenes. She was discharged from the hospital on the 18th day and subsequently received ampicillin (4g/d) perorally for 7 days.
A 42-year-old man was admitted to the dermatology unit because of pemphigus vulgaris. He was being treated with methylprednisolone, ranitidine and hydrotalcid. On day 43 of admission, meningoencephalitis occurred, characterized by a sudden onset of fever (temperature 39.2℃), meningeal signs and disturbances of consciousness. The meningeal syndrome was associated with purulent CSF pleocytosis with a predominance of polymorphonuclear leukocytes (PMNs). He was transferred into the infectious diseases unit. The CSF culture was positive for serotype 1 of the L. monocytogenes. Blood cultures were negative. A combination of penicillin G (20MU/d) and amikacin (1g/d) was administered to the patient. The patient's condition began to deteriorate despite intensive supportive therapy and he died on the fourth day of the antibiotic therapy.