Abstract: Rituximab is a monoclonal antibody intended for the treatment of various autoimmune conditions as well as B-cell lymphoid malignancies. It is targeted to the CD20 antigen, which induces apoptosis in mature B cells, making it a useful therapeutic agent against B-cell lymphoid malignancies when used in conjunction with cytotoxic chemotherapy regimens such as cyclophosphamide, hydroxydaunorubicin (doxorubicin), Oncovin (vincristine; Hospira Inc, Lake Forest Ill), and prednisone/prednisolone. It is a very successful treatment of B-cell malignancies but causes profound immunosuppression and elevates the risk of opportunistic infections such as enterovirus meningitis. We report a case of aseptic meningitis in a patient with non-Hodgkin lymphoma after treatment with rituximab in combination with cytotoxic chemotherapy and successful treatment with intravenous immunoglobulin therapy.
Prolonged periods of B-cell deficiency caused by rituximab increases the risk for infections by attacking the antibodies which are the body&#x2019;s natural protection against some of the viral infections such as enterovirus. Givens et al. report a case of persistent enterovirus meningoencephalitis in patient with NHL after rituximab therapy. The patient was successfully treated with intravenous immunoglobulin with complete resolution of the symptoms.
From the *Division of Infectious Diseases and International Medicine, Department of Internal Medicine, University of South Florida College of Medicine; †Clinical Microbiology and Virology Laboratories, H. Lee Moffitt Cancer Center and Research Institute; ‡Department of Pathology and Oncologic Sciences, University of South Florida College of Medicine; §Division of Infectious Diseases, H. Lee Moffitt Cancer Center and Research Institute; ∥Department of Internal Medicine and Interdisciplinary Oncology, University of South Florida College of Medicine, Tampa, FL.
Correspondence to: John N. Greene, MD, FACP, Division of Infectious Diseases, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, FOB-3, Tampa, FL 33612-9497. E-mail: firstname.lastname@example.org.
The authors have no funding or conflicts of interest to disclose.
Priscilla Givens is a medical student at the University of South Florida, Tampa, FL.