title: Listeria meningitis complicating a patient with ulcerative colitis on concomitant infliximab and hydrocortisone.
abstract: Infliximab, a monoclonal antibody directed against tumour necrosis factor, is an effective therapy for moderate-to-severe ulcerative colitis and Crohn's disease. Uncommonly, serious opportunistic infections have occurred in patients after infliximab administration. Here, we describe meningitis caused by Listeria monocytogenes developing in a 37-year-old man with ulcerative colitis refractory to intravenous corticosteroids 10 days after receiving his first infusion of infliximab. With the increasing use of tumour necrosis factor-α-neutralizing agents, clinicians should be aware of the risk of opportunistic infections caused by L. monocytogenes in patients with inflammatory bowel disease following infliximab treatment. The half-life of infliximab is 9.5 days; therefore, patients tend to be more susceptible in the immediate period following infusion. Patients receiving anti-TNF therapy should be advised to avoid foods such as soft cheeses and unpasteurized dairy products.
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland. vikpar37@yahoo.com.
authors.forename: V
authors.initials: V
authors.lastname: Parihar
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: Maguire
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Shahin
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: Z
authors.initials: Z
authors.lastname: Ahmed
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: O'Sullivan
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Kennedy
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Smyth
authors.affiliation: Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Farrell
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D000069285:Infliximab / Q000009:adverse effects*; D008297:Male; D008584:Meningitis, Listeria / Q000139:chemically induced*; D009894:Opportunistic Infections / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D006854:Hydrocortisone
keywords: Hydrocortisone; Inflammatory bowel disease; Infliximab; Listeria meningitis