Brain abscesses complicating acute pneumococcal meningitis during etanercept therapy.
Brain abscess formation as a sequelae of community-acquired pneumococcal meningitis is extremely rare, accounting for less than 1% of all meningitis complications. Although metastatic seeding from a distal peripheral septic focus has been observed, this phenomenon most commonly occurs in the context of ear, nose and throat infections, post-cranial neurosurgical procedures, traumatic open cranial injury, or immunosuppression. We present the case of a man, 61 years old, on etanercept therapy for ankylosing spondylitis who developed multiple brain abscesses as a complication of pneumococcal meningitis. We believe that the predisposition to this extremely rare complication of a particularly aggressive pneumococcal meningitis was most likely due to the underlying immunosuppression resulting from etanercept therapy. As far as we know, this case is the first report linking multiple brain abscess formation in a patient with community-acquired pneumococcal meningitis with etanercept therapy.
Department of Internal Medicine, Marshfield Clinic-Park Falls Center, Park Falls, WI 54552, USA. kasirye.yusuf@marshfieldclinic.org
Yusuf
Y
Kasirye
Narendranath
N
Epperla
Janaki Ram
JR
Manne
Sowjanya
S
Bapani
Romel J
RJ
Garcia-Montilla
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001922:Brain Abscess / Q000209:etiology*; D000068800:Etanercept; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000009:adverse effects*; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications*; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000188:drug therapy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept