Simultaneous CMV and Listeria infection following alemtuzumab treatment for multiple sclerosis

Alemtuzumab, a humanized monoclonal antibody for the treatment of relapsing-remitting multiple sclerosis, produce the rapid depletion of all mature lymphocytes. For this reason, patients are at an increased risk of developing infections due to the reactivation of latent agents or acquired microorganisms. Most infections reported during the phase III trials were mild or moderate in severity, while serious infections were surprisingly uncommon.1 However, during the postmarketing use of alemtuzumab, several opportunistic infections have been reported.2–5 We describe a patient who presented simultaneous cytomegalovirus (CMV) reactivation and Listeria meningitis promptly following the first course of alemtuzumab.