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Background <p>Enterovirus infection has been described as a cause of severe viral sepsis in humorally immunosuppressed patients.</p> Case presentation <p>A 20-year-old female with a history of multiple sclerosis on ocrelizumab therapy with persistent agammaglobulinemia and autoimmune hepatitis treated with azathioprine/budesonide presented with subacute sensorineural hearing loss, hepatitis, pneumonia, enterocolitis and pancreatitis. Molecular pathological techniques detected enterovirus RNA in samples from the liver, blood, ascites fluid, and pleural effusions, confirming Echovirus serotype 11. The case was managed successfully with supportive care and high-dose intravenous immunoglobulins in addition to fluoxetine.</p> Discussion and conclusions <p>This patient’s unique presentation and clinical course presents important implications for the care of immunosuppressed patients with cryptic complaints.</p>

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Echovirus serotype 11 induced sepsis in a young female patient with multiple sclerosis treated with anti-CD20 monoclonal antibody ocrelizumab

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  • 发表日期：

    2025年2月5日

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  • A. D. Starosta,
  • J. Ehler,
  • B. Löffler,
  • A. Tannapfel,
  • A. Zipprich,
  • P. A. Reuken,
  • A. Stallmach

摘要

Background

Enterovirus infection has been described as a cause of severe viral sepsis in humorally immunosuppressed patients.

Case presentation

A 20-year-old female with a history of multiple sclerosis on ocrelizumab therapy with persistent agammaglobulinemia and autoimmune hepatitis treated with azathioprine/budesonide presented with subacute sensorineural hearing loss, hepatitis, pneumonia, enterocolitis and pancreatitis. Molecular pathological techniques detected enterovirus RNA in samples from the liver, blood, ascites fluid, and pleural effusions, confirming Echovirus serotype 11. The case was managed successfully with supportive care and high-dose intravenous immunoglobulins in addition to fluoxetine.

Discussion and conclusions

This patient’s unique presentation and clinical course presents important implications for the care of immunosuppressed patients with cryptic complaints.