Listeria monocytogenes bacteremia and meningitis in HIV-infected patients: Report of 2 cases and review of literature

Listeria monocytogenes is the causative agent of listeriosis, a potentially fatal food-borne infection in humans. Listeriosis is an infrequent disease in HIV-infected patients. In the pre-highly active antiretroviral therapy era, however, patients with AIDS had a 145 times increased risk for invasive listeriosis compared with the general population. Cases of listeriosis continue to be reported in HIV-infected patients. We report a case of an African man living in New York who presented with febrile illness and L. monocytogenes bacteremia. The Gram stain from blood cultures showed diphtheroid-like organisms, which were considered contaminants. He received vancomycin and quickly defervesced. The blood culture isolates were finalized as L. monocytogenes. The second report is of an African American woman. She was not in medical care and had a very low CD4⁺ T-cell count. She presented with L. monocytogenes bacteremia and meningitis and died despite appropriate therapy.