Listeria meningitis complicating a patient with ulcerative colitis on concomitant infliximab and hydrocortisone

Ir J Med Sci. 2016 Nov;185(4):965-967. doi: 10.1007/s11845-015-1355-9. Epub 2015 Sep 10.

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.

Keywords: Hydrocortisone; Inflammatory bowel disease; Infliximab; Listeria meningitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / drug therapy
  • Female
  • Gastrointestinal Agents / adverse effects*
  • Humans
  • Hydrocortisone / therapeutic use
  • Infliximab / adverse effects*
  • Male
  • Meningitis, Listeria / chemically induced*
  • Opportunistic Infections / chemically induced*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Adrenal Cortex Hormones
  • Gastrointestinal Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Hydrocortisone