Immunocompromised Child on Infliximab: A Case Report of Listeria monocytogenes Meningitis

Clinical Practice and Cases in Emergency Medicine
Camille HalfmanSamantha Jones

Abstract

Patients with naturally occurring, impaired cell-mediated immunity secondary to age and pregnancy are known to be at risk of developing severe and invasive Listeria monocytogenes infections. Immunosuppressant medications, particularly infliximab, are also known to increase this risk. We present the case of a seven-year-old female on infliximab who was diagnosed with culture positive L. monocytogenes meningitis after a negative cerebral spinal fluid polymerase chain reaction (PCR). Patients receiving infliximab who display signs of central nervous system infection should be suspected to have L. monocytogenes as an infecting agent, and empiric addition of ampicillin to their antibiotic regimen should be considered, with substitution of trimethoprim-sulfamethoxazole in cases of penicillin allergy, regardless of initial PCR results.

References

Jan 1, 1972·Antimicrobial Agents and Chemotherapy·R C MoelleringL J Kunz
Jan 27, 2004·The Annals of Pharmacotherapy·Venita L BowieParag Bharadwaj
Sep 16, 2011·Journal of Clinical Microbiology·Alban Le MonnierSamer Kayal
Apr 8, 2016·Pediatric Emergency Care·Giovanna VillaSalvatore Renna
Jul 20, 2016·Pediatrics·H Dele Davies, UNKNOWN COMMITTEE ON INFECTIOUS DISEASES
Feb 1, 2017·The Lancet Infectious Diseases·Caroline CharlierUNKNOWN MONALISA study group
Jun 8, 2018·Pediatrics International : Official Journal of the Japan Pediatric Society·Asami ShimboMasayuki Shimohira
Dec 31, 2018·Italian Journal of Pediatrics·Massimo Luca CastellazziSamantha Bosis

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Methods Mentioned

BETA
sedation
PCR

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