Clinical Institute, Aarhus University, Aarhus, Denmark
Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark.
BMJ Case Rep. 2023 Sep 26;16(9):e256029. doi: 10.1136/bcr-2023-256029.
Infections caused by in immune-competent people are typically simple and uncomplicated. However, in cases of immunosuppression, severe disseminated infections can occur.This case report describes the case of a severe, disseminated infection caused by in a young female with unacknowledged humoral immunosuppression due to treatment with ocrelizumab for multiple sclerosis.The patient was admitted due to a recurrent episode of a tubo-ovarian abscess. Throughout the following 2 months of hospitalisation, treatment with several types of antibiotics and the placement of various drains led to no improvement. As extensive investigations indicated hypogammaglobulinaemia, was suspected, and tests came back positive. Treatment with doxycycline and moxifloxacin led to a full recovery.This demonstrates how humoral immunosuppression is a risk factor for severe disseminated infections and how these may be avoided through monitoring of immunoglobulin levels in patients treated with ocrelizumab.
免疫功能正常者感染通常较为简单且不复杂。然而，在免疫抑制的情况下，可能会发生严重的播散性感染。本病例报告描述了一例因多发性硬化症接受奥瑞珠单抗治疗而导致体液免疫抑制未被识别的年轻女性发生严重播散性感染的病例。患者因复发性输卵管卵巢脓肿而入院。在接下来的 2 个月住院期间，尽管使用了多种类型的抗生素和放置了各种引流管，病情仍未见改善。由于广泛的检查提示低丙种球蛋白血症，故怀疑为感染，检测结果呈阳性。使用多西环素和莫西沙星治疗后患者完全康复。本病例说明了体液免疫抑制是严重播散性感染的危险因素，以及如何通过监测接受奥瑞珠单抗治疗的患者的免疫球蛋白水平来避免此类感染。
