title: Leuconostoc sp. Meningitis in a Patient Treated with Rituximab for Mantle Cell Lymphoma.
abstract: We present a 64-year-old man who was treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemoimmunotherapy for mantle cell lymphoma and developed purulent meningitis, probably caused by Leuconostoc sp. The patient had severe hypogammaglobulinemia, which is a possible complication of rituximab therapy. To our knowledge and after reviewing the available medical literature, this is the first described case of purulent meningitis caused by Leuconostoc sp. in a patient with mantle cell lymphoma that appeared after treatment with the R-CHOP protocol. The diagnosis of purulent meningitis was based on clinical, laboratory and cytological cerebrospinal fluid findings, in addition to blood culture results in which we isolated Leuconostoc sp. The patient was treated with meropenem with full recovery.
authors.affiliation: General Hospital Dr. Josip Benčević, Clinic of Internal Medicine, Slavonski Brod, Croatia Phone: 0038535201688 E-mail: hholik@gmail.com.
authors.forename: Hrvoje
authors.initials: H
authors.lastname: Holik
authors.forename: Božena
authors.initials: B
authors.lastname: Coha
authors.forename: Marijan
authors.initials: M
authors.lastname: Šiško
authors.forename: Maja
authors.initials: M
authors.lastname: Tomić-Paradžik
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007934:Leuconostoc / Q000302:isolation & purification* / Q000472:pathogenicity; D020522:Lymphoma, Mantle-Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000209:etiology*; D000077731:Meropenem; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology*; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects*; D013845:Thienamycins / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000069283:Rituximab; D000077731:Meropenem