Listerial meningitis and renal allografts: a life-threatening affinity

Two cases of Listeria monocytogenes infection in patients receiving immunosuppressive treatment after kidney transplantation are described. In the first, the infection, which occurred soon after transplantation and was accompanied by signs of mild chronic rejection, was the immediate cause of death. The other case occurred in a patient whose transplanted kidney had been functioning well for more than four years; this patient recovered. These cases, plus a review of 40 similar cases in the literature, point out the importance of anticipating possible listerial infection when septic meningitis arises in a patient with a transplanted kidney.