Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis

Abstract Nowadays B-cell depletion via anti-CD20 antibodies is commonly applied in the treatment of multiple sclerosis (MS). Yet, not much is known about infection risks associated with long-term B-cell depletion in the specific context of MS. We present the case of a 45-year-old male patient who de...

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Main Authors: Carolin Schwake, Ralf Gold
Format: Article
Language:English
Published: BMC 2020-10-01
Series:Neurological Research and Practice
Subjects:
Online Access:http://link.springer.com/article/10.1186/s42466-020-00074-0
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spelling doaj-f25077feae5d4bdf844704164060bbef2020-11-25T02:25:45ZengBMCNeurological Research and Practice2524-34892020-10-01211310.1186/s42466-020-00074-0Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosisCarolin Schwake0Ralf Gold1Department of Neurology, St. Josef-Hospital, Ruhr-University BochumDepartment of Neurology, St. Josef-Hospital, Ruhr-University BochumAbstract Nowadays B-cell depletion via anti-CD20 antibodies is commonly applied in the treatment of multiple sclerosis (MS). Yet, not much is known about infection risks associated with long-term B-cell depletion in the specific context of MS. We present the case of a 45-year-old male patient who developed severe pneumonia following 6 years of rituximab treatment for highly active relapsing-remitting MS. The patient had no additional chronic disease as well as no history of foreign travel. Although the unusual formation of a pulmonary cavity raised suspicion for tuberculosis, repeated testing via bronchoscopy and sputum remained negative. Prolonged antibiotic therapy with piperacillin/tazobactam and amoxicillin/ clavulanate led to complete recovery from symptoms. This case shows the potential risk of serious infections following continuous B-cell depletion in MS and illustrates the importance of future vigilance.http://link.springer.com/article/10.1186/s42466-020-00074-0Multiple sclerosisRituximabPneumoniaPulmonary cavity
collection DOAJ
language English
format Article
sources DOAJ
author Carolin Schwake
Ralf Gold
spellingShingle Carolin Schwake
Ralf Gold
Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis
Neurological Research and Practice
Multiple sclerosis
Rituximab
Pneumonia
Pulmonary cavity
author_facet Carolin Schwake
Ralf Gold
author_sort Carolin Schwake
title Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis
title_short Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis
title_full Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis
title_fullStr Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis
title_full_unstemmed Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis
title_sort severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis
publisher BMC
series Neurological Research and Practice
issn 2524-3489
publishDate 2020-10-01
description Abstract Nowadays B-cell depletion via anti-CD20 antibodies is commonly applied in the treatment of multiple sclerosis (MS). Yet, not much is known about infection risks associated with long-term B-cell depletion in the specific context of MS. We present the case of a 45-year-old male patient who developed severe pneumonia following 6 years of rituximab treatment for highly active relapsing-remitting MS. The patient had no additional chronic disease as well as no history of foreign travel. Although the unusual formation of a pulmonary cavity raised suspicion for tuberculosis, repeated testing via bronchoscopy and sputum remained negative. Prolonged antibiotic therapy with piperacillin/tazobactam and amoxicillin/ clavulanate led to complete recovery from symptoms. This case shows the potential risk of serious infections following continuous B-cell depletion in MS and illustrates the importance of future vigilance.
topic Multiple sclerosis
Rituximab
Pneumonia
Pulmonary cavity
url http://link.springer.com/article/10.1186/s42466-020-00074-0
work_keys_str_mv AT carolinschwake severepneumoniawithformationofapulmonarycavityassociatedwithlongtermrituximabtherapyinmultiplesclerosis
AT ralfgold severepneumoniawithformationofapulmonarycavityassociatedwithlongtermrituximabtherapyinmultiplesclerosis
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