title: Brain abscess following rituximab infusion in a patient with pemphigus vulgaris.
abstract: BACKGROUND
  Immunocompromised patients are at increased risk for developing meningitis or, rarely, brain abscess with opportunistic organisms like Listeria monocytogenes.
  
  
  METHODS
  A 52 year-old Saudi Arabian woman who was diagnosed with pemphigus vulgaris and diabetes and had been on prednisolone and azathioprine for about 4 years. She presented with headache, low-grade fever, and left-sided weakness 2 weeks after receiving the second dose of rituximab infusion. Magnetic resonance imaging revealed an enhanced space-occupying lesion with multiple small cyst-like structures and vasogenic edema in the right temporoparietal area. Her blood culture was positive for Listeria monocytogenes, and a brain biopsy showed necrotic tissues with pus and inflammatory cells. She recovered after a 6-week course of antibiotics with ampicillin and gentamycin.
  
  
  CONCLUSIONS
  Brain abscess due to Listeria monocytogenes is a risk that should be considered when adding rituximab to the regimen of a patient who is already Immunocompromised.
authors: Department of Neurology, Neuroscience Centre, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
authors: Talal M
authors: TM
authors: Al-Harbi
authors: Department of Neurology, Neuroscience Centre, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
authors: Shahad A
authors: SA
authors: Al-Muammar
authors: Department of Neuroscience, University of California, San Diego, CA, USA.
authors: Ronald J
authors: RJ
authors: Ellis
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects*; D018951:Antigens, CD20; D001922:Brain Abscess / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010392:Pemphigus / Q000150:complications*; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007155:Immunologic Factors; D000069283:Rituximab