Joosten A A, van Olffen G H, Hageman G
Afd. Neurologie, Medisch Spectrum Twente, Postbus 50.000, 7500 KA Enschede.
Ned Tijdschr Geneeskd. 2003 Jul 26;147(30):1470-2.
A 41-year-old woman was admitted to the hospital with meningitis caused by Listeria monocytogenes. Because of her Crohn's disease she used prednisolone and azathioprine. Two weeks before presenting with meningitis, infliximab had been given as the other immunosuppressant drugs had no effect. This tumour necrosis factor alpha (TNF alpha) blocking agent is known to increase the risk of opportunistic infections. This is the first Dutch patient described with meningitis caused by L. monocytogenes after treatment with infliximab. She recovered after antibiotic therapy. When antibiotic treatment is chosen, the possibility of opportunistic infections in patients who use infliximab concurrently with other immunosuppressant drugs should be taken into account.
一名41岁女性因单核细胞增生李斯特菌引起的脑膜炎入院。由于她患有克罗恩病,一直在使用泼尼松龙和硫唑嘌呤。在出现脑膜炎前两周,因其他免疫抑制药物无效,开始使用英夫利昔单抗。已知这种肿瘤坏死因子α(TNFα)阻断剂会增加机会性感染的风险。这是荷兰首例报道的在用英夫利昔单抗治疗后发生单核细胞增生李斯特菌脑膜炎的患者。她在接受抗生素治疗后康复。选择抗生素治疗时,应考虑同时使用英夫利昔单抗和其他免疫抑制药物的患者发生机会性感染的可能性。