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利斯特菌脑膜炎并发于英夫利昔单抗治疗克罗恩病。

Listeria meningitis complicating infliximab treatment for Crohn's disease.

机构信息

Department of Internal Medicine, South-East Health Care Authority, The Moncton Hospital, Moncton, New Brunswick.

出版信息

Can J Infect Dis Med Microbiol. 2005 Sep;16(5):289-92. doi: 10.1155/2005/814698.

Abstract

Infliximab, a monoclonal antibody directed against tumour necrosis factor-alpha, is an effective therapy for Crohn's disease. Though uncommon, serious opportunistic infections, including reactivation of tuberculosis, have occurred in patients after infliximab administration.Meningitis caused by Listeria monocytogenes developed in a 37-year-old man six days after the second infusion of infliximab. The patient, who also was treated with azathioprine and corticosteroids, had an uneventful recovery after a course of antibiotics. Several other recent reports have implicated infliximab therapy in the development of severe Listeria infections, particularly meningitis and sepsis. With the increasing use of tumour necrosis factor-alpha-neutralizing agents, clinicians should be aware of the risk of opportunistic infections caused by L monocytogenes in patients with Crohn's disease following infliximab treatment.

摘要

英夫利昔单抗是一种针对肿瘤坏死因子-α的单克隆抗体,是治疗克罗恩病的有效方法。尽管不常见,但在英夫利昔单抗治疗后,患者会发生严重的机会性感染,包括结核分枝杆菌的再激活。利斯特菌脑膜炎发生在一名 37 岁男性第二次输注英夫利昔单抗后 6 天。该患者还接受了硫唑嘌呤和皮质类固醇治疗,在接受抗生素治疗后恢复顺利。最近的其他几份报告表明,英夫利昔单抗治疗与严重李斯特菌感染(特别是脑膜炎和败血症)的发生有关。随着肿瘤坏死因子-α中和剂的使用增加,临床医生应该意识到在接受英夫利昔单抗治疗后,克罗恩病患者发生李斯特菌感染的机会性感染的风险。

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