Meningism in a ten-month-old infant during OKT3 therapy

Organ transplantation has become widely applied as a therapy of end-stage organ dysfunction and is finding increasing application in the pediatric population. This has become possible largely through the use of improved immunosuppressive agents, such as OKT3. Aseptic meningitis associated with OKT3 has been previously reported, with a frequency rate of 3% to 14%, in adult renal allograft recipients. Aseptic meningitis after OKT3 therapy has not been reported in children. Meningitis, however, is a frequent infection encountered in young children, and the development of meningeal irritation during therapy with OKT3 may present a diagnostic dilemma. We describe aseptic meningitis in a 10-month-old infant after treatment of cardiac allograft rejection with OKT3.