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Brain abscesses complicating acute pneumococcal meningitis during etanercept therapy
Yusuf Kasirye1, Narendranath Epperla, Janaki Ram Manne
1Department of Internal Medicine, Marshfield Clinic-Park Falls Center, Park Falls, WI 54552, USA. kasirye.yusuf@marshfieldclinic.org
Clinical Medicine & Research
|May 29, 2012
Summary
Brain abscesses are a rare complication of pneumococcal meningitis. This case highlights a potential link between etanercept therapy for ankylosing spondylitis and multiple brain abscesses.
Area of Science:
- Neurology
- Infectious Diseases
- Rheumatology
Background:
- Community-acquired pneumococcal meningitis can lead to rare complications.
- Brain abscess formation is an infrequent sequela, occurring in less than 1% of meningitis cases.
- Metastatic seeding of brain abscesses typically arises from specific conditions like ENT infections or immunosuppression.
Observation:
- A 61-year-old male patient with ankylosing spondylitis on etanercept therapy developed multiple brain abscesses.
- The patient's condition was a complication of community-acquired pneumococcal meningitis.
- This presentation is considered extremely rare.
Findings:
- The study presents the first reported case of multiple brain abscesses linked to community-acquired pneumococcal meningitis in a patient undergoing etanercept therapy.
- The authors hypothesize that etanercept-induced immunosuppression predisposed the patient to this severe complication.
- The aggressive nature of the pneumococcal meningitis in this context is noted.
Implications:
- This case underscores the potential risk of serious infections, such as brain abscesses, in patients on immunosuppressive therapy like etanercept.
- It highlights the importance of considering iatrogenic immunosuppression as a contributing factor in rare infectious complications.
- Further vigilance and research may be warranted for patients on etanercept, particularly those with inflammatory conditions and exposure to infections.
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