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Intractable pneumococcal meningoencephalitis associated with a TNF-α antagonist
Seok-Jae Kang1, Hyun Young Kim1, Young Seo Kim1
1Departments of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Abstract:
A 34-year-old man was treated with a TNF-α antagonist for ankylosing spondylitis, and this subsequently developed a CNS infection. Magnetic resonance imaging showed diffuse subcortical white matter lesions. Streptococcus pneumoniae was cultured from the cerebrospinal fluid and blood. The patient died of multifocal widespread brain damage and subarachnoid hemorrhage, despite intensive antibacterial medication. Pneumococcal meningoencephalitis can occur in association with TNF-α antagonists. Clinicians should be aware of both the risk of fatal bacterial meningoencephalitis associated with TNF-α antagonists and the possibility of an unusual presentation of bacterial meningitis.
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