Case Report

Journal of NeuroVirology

, Volume 17, Issue 3, pp 288-290

First online:

Natalizumab and HSV meningitis

  • Erica Seiguer ShenoyAffiliated withDivision of Infectious Diseases, Massachusetts General HospitalHarvard Medical School Email author 
  • , Eleftherios MylonakisAffiliated withDivision of Infectious Diseases, Massachusetts General HospitalHarvard Medical School
  • , Rocio M. HurtadoAffiliated withDivision of Infectious Diseases, Massachusetts General HospitalHarvard Medical School
  • , Nagagopal VennaAffiliated withDepartment of Neurology, Massachusetts General Hospital

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Abstract

Natalizumab (Tysabri, Biogen Idec and Elan Pharmaceuticals) is a monoclonal antibody approved for use in patients with relapsing multiple sclerosis (MS) as well as moderate to severe Crohn’s disease. We report the first case of a patient with a history of MS, on monthly natalizumab, who developed HSV-2 meningitis. We discuss the mechanism of action of natalizumab and review what is known about the reactivation of herpes infection in association with this medication. The question of herpes simplex virus (HSV) and varicella zoster virus (VZV) prophylaxis for patients is raised.