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Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...

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Induction of Leptomeningeal Cells Modification Via Intracisternal Injection

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Bacterial meningitis associated with infliximab.

Raymond Farah¹, Svetlana Lisitsin, Moshe Shay

¹Department of Internal Medicine F-Nahariya Hospital, B. Rappaport Faculty of Medicine, Western Galilee Hospital, 21, 22100 Technion, Nahariya, Israel. Raymond.Farah@naharia.health.gov.il

Pharmacy World & Science : PWS

|September 28, 2006

Summary

A woman treated with infliximab for Wegener's granulomatosis developed bacterial meningitis. Prompt diagnosis and treatment of Streptococcus pneumoniae infection led to a positive outcome.

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Area of Science:

Immunology
Neurology
Infectious Diseases

Background:

Wegener's granulomatosis is a rare autoimmune disease.
Infliximab is a biologic therapy used to treat autoimmune conditions.
Biologic therapies can increase the risk of serious infections.

Observation:

A 45-year-old woman with Wegener's granulomatosis was treated with infliximab.
Six months after starting infliximab, she presented with fever, neck stiffness, and altered mental state.
Cerebral edema was noted on CT scan.

Findings:

Blood and cerebrospinal fluid (CSF) cultures isolated Streptococcus pneumoniae.
The patient was diagnosed with bacterial meningitis.
The clinical presentation was consistent with classic meningitis symptoms.

Implications:

Infliximab treatment may be associated with an increased risk of bacterial meningitis.
Early recognition of meningitis symptoms in patients on infliximab is crucial.
Prompt antibiotic treatment is essential for favorable outcomes in bacterial meningitis.