Immunocompromised Child on Infliximab: A Case Report of Listeria monocytogenes Meningitis

Abstract

Introduction: Patients with naturally occurring, impaired cell-mediated immunity secondary to age and pregnancy are known to be at risk of developing severe and invasive Listeria monocytogenes infections. Immunosuppressant medications, particularly infliximab, are also known to increase this risk. Case Report: We present the case of a seven-year-old female on infliximab who was diagnosed with culture positive L. monocytogenes meningitis after a negative cerebral spinal fluid polymerase chain reaction (PCR). Conclusion: Patients receiving infliximab who display signs of central nervous system infection should be suspected to have L. monocytogenes as an infecting agent, and empiric addition of ampicillin to their antibiotic regimen should be considered, with substitution of trimethoprim-sulfamethoxazole in cases of penicillin allergy, regardless of initial PCR results.

A human immunodeficiency virus-seronegative acquired immunodeficiency syndrome patient with opportunistic infections: A case report

“…Anti-TNF-α therapy seemed to be well tolerated in people living with HIV, 7 but infliximab could induce opportunistic infections, such as histoplasmosis, 8 Mycobacterium marinum infection 9 and Listeria monocytogenes meningitis. 10 Thus, infliximab administration might contribute to HIV activation and AIDS progression. Use of immunosuppressive therapy may give rise to atypical presentation of HIV-1 infection.…”