Listeria and alemtuzumab

Holmøy T, von der Lippe H, Leegaard TM.Listeria monocytogenes infection associated with alemtuzumab – – a case for better preventive strategies.BMC Neurol. 2017;17(1):65.

BACKGROUND:The mortality of septicaemia, meningitis and encephalitis caused by Listeria monocytogenes is 20-40%. Twenty-one cases of invasive listeriosis associated with alemtuzumab, including at least 16 in patients with multiple sclerosis, have been published or reported to the World Health Organization Case Safety Reports Database. Three cases were fatal, including at least one patient treated for multiple sclerosis in 2016.
CASE PRESENTATION:We report a patient with multiple sclerosis who developed pyrexia, nausea and abdominal discomfort few hours after the third and last infusion of her second alemtuzumab cycle. An infusion related reaction was suspected. The patient had however eaten soft cheese and raw sausage 3 days prior to treatment, and L. monocytogenes septicaemia was diagnosed based on positive blood cultures.
CONCLUSION:Listeriosis associated with alemtuzumab is a potentially fatal condition that can mimic an infusion related reaction. As in most other previously reported cases symptoms started rapidly after the last infusion, suggesting that the patient already carried the bacteria prior to the alemtuzumab infusions. The summary of product characteristics recommends patients to avoid foods associated with listeria at least 1 month after treatment. This recommendation should include also the last weeks prior to treatment.

Yet another case of Listeria on alemtuzumab. But in this case they were eating non-pastuerised cheese just before removal of all their immune system. Not recomended

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  • Not sure how many times I will feel the urge to say thanks for the posts on this site, but this is yet another occasion. Thanks MD – knowledge is empowering and as I'm due my second dose in November it feels beneficial to know that listeriosis can mimic infusion reactions. Whilst I will, of course, be following the new advice to follow the listeria diet prior as well as post infusion, it's good to know I can/should screech loudly if I have a reaction I think should be checked out!

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