Listerial myocarditis in cardiac transplantation. Rev. Infect. Dis

Clinical signs of heart failure developed in two cardiac transplant recipients and were interpreted initiallyas graft rejection. Morphologic examination ofexplanted hearts revealed myocarditis with abscess formation and necrosisconsistent with a bacterial process; Listeria monocytogenes was isolated from myocardial tissue in the first case and from blood in both. The first patient also developed signs of meningoencephalitis, but the second had no signs of infection outside the heart. Antimicrobial therapy and retransplantation were successful in eradicating listeriosis. The differential diagnosis of heart failure in cardiac transplant recipients includes infectious myocarditis due to L. monocytogenes. Opportunistic infections are a common complica-tion of organ transplantation with immunosuppres-sive therapy. Listeria monocytogenes is well known as a cause of meningitis, parenchymal disease of the CNS, and primary bacteremia [1]. Less commonly, and generally in patients with underlying heart dis-ease rather than in those receiving immunosuppres