Listeria infection in transplant patients. Five cases and a review of the literature.

We report five cases of Listeria monocytogenes infection in renal transplant patients at the University of Minnesota and compare them to 15 additional patients reported on in the United States literature. All patients were noted to have fever, malaise, and nonspecific symptoms of infection. There were no consistent diagnostic laboratory findings except for positive bacteriologic studies. Successful treatment consisted of intravenous penicillin G potassium in most cases (ampicillin sodium was required in two patients). Mortality was low, with only one patient of the 20 (and no Minnesota patients) dying of listeriosis. The time interval from transplant to infection was definitively longer in the Minnesota patients; this may be due to the routine use of sulfisoxazole following renal transplantation. Listeria infection, though mild itself, may herald other infectious processes in the immunoincompetent host.