Published in:
01-11-2016 | Case Based Review
Listeria meningitis complicating a patient with ulcerative colitis on concomitant infliximab and hydrocortisone
Authors:
V. Parihar, S. Maguire, A. Shahin, Z. Ahmed, M. O’Sullivan, M. Kennedy, C. Smyth, R. Farrell
Published in:
Irish Journal of Medical Science (1971 -)
|
Issue 4/2016
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Abstract
Infliximab, a monoclonal antibody directed against tumour necrosis factor, is an effective therapy for moderate-to-severe ulcerative colitis and Crohn’s disease. Uncommonly, serious opportunistic infections have occurred in patients after infliximab administration. Here, we describe meningitis caused by Listeria monocytogenes developing in a 37-year-old man with ulcerative colitis refractory to intravenous corticosteroids 10 days after receiving his first infusion of infliximab. With the increasing use of tumour necrosis factor-α-neutralizing agents, clinicians should be aware of the risk of opportunistic infections caused by L. monocytogenes in patients with inflammatory bowel disease following infliximab treatment. The half-life of infliximab is 9.5 days; therefore, patients tend to be more susceptible in the immediate period following infusion. Patients receiving anti-TNF therapy should be advised to avoid foods such as soft cheeses and unpasteurized dairy products.