Meningococcal meningitis in patients under prolonged eculizumab therapy: Clinical and immunological observations from a case series.
Rubén Varela-Fernández, Luis Ortega-Valín, Mónica Sáez-Villafañe et al.
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Case in brief
Two patients undergoing prolonged eculizumab therapy developed meningococcal meningitis despite prior vaccination. The clinical presentation included typical symptoms of meningitis, and diagnostic workups confirmed the infection. Both cases highlighted the challenges in managing infection risk in patients with compromised immune responses due to complement inhibition. The patients were treated with appropriate interventions, leading to recovery.
Diagnostic / clinical pearl
Clinicians should be aware that patients on eculizumab remain at high risk for meningococcal infections, even with prior vaccination, necessitating careful monitoring and individualized preventive strategies.
Why it matters
This case underscores the need for ongoing evaluation of vaccination efficacy and infection prevention in patients receiving complement inhibitors, as traditional immunization may not provide adequate protection.