Skip to content
DraconiticResearch
Search Sources API
197,785 studies31 sourcesUpdated 27 min ago
Peer-reviewedCC BY-NC-NDJournal of medical case reports

Disseminated Ureaplasma urealyticum infection presenting as systemic inflammatory syndrome in ocrelizumab-treated patients with multiple sclerosis: a case series.

  • Anna Witkowska1
  • Fionnuala Cahill2
  • Killian O'Rourke3
  • Padraig McGettrick4
  • Tomás Burke5
  • Geraldine McCarthy2
  • Joanne Kitchen2
  • Abdalla Abuelmagd2
  • John Stack2
5 affiliations
  1. 1Rheumatology Department, Mater Misericordiae University Hospital, Dublin, Ireland. [email protected].
  2. 2Rheumatology Department, Mater Misericordiae University Hospital, Dublin, Ireland.
  3. 3Neurology Department, Mater Misericordiae University Hospital, Dublin, Ireland.
  4. 4Infectious Diseases Department, Mater Misericordiae University Hospital, Dublin, Ireland.
  5. 5Ophthalmology Department, Mater Misericordiae University Hospital, Dublin, Ireland.
Read full textPDFDOICite

Abstract

Background

Ocrelizumab, an anti-CD20 monoclonal antibody, is widely used to treat multiple sclerosis (MS), inducing profound B-cell depletion and disease remission. However, it may rarely lead to opportunistic infections. We report two patients with MS on ocrelizumab who developed unique complications of anti-CD20 antibody therapy. One patient developed fulminant endophthalmitis, a novel complication that has not been previously reported.Case presentation

A 38-year-old female of South Asian descent and a 46-year-old White female, both with MS on ocrelizumab, developed disseminated Ureaplasma urealyticum infection which was initially misdiagnosed as reactive arthritis in both cases. Both patients deteriorated following immunosuppression, with one developing fulminant endophthalmitis. Diagnosis was established via broad-range PCR from synovial and ocular samples. Prolonged antimicrobial and glucocorticoid therapy led to resolution in both cases.Conclusions

Novel B-cell targeting agents can be effective treatments for MS; however, their use may be associated with potentially life-threatening complications. These two cases highlight the diagnostic and therapeutic challenges associated with opportunistic infections in the context of anti-CD20 monoclonal antibody therapy.

Related

  1. Peritoneal dialysis-associated peritonitis caused by Ureaplasma urealyticum : A case report
    Ting Hu, Jinjin Zhang, Geping Yu
    MedicinePeer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. Disseminated Pulmonary Coccidioidomycosis Presenting as a Wedge-Shaped Necrotic Mass Mimicking Malignancy
    Tanveer Singh, Sharanya Thiagarajan, Igor Gorodniuk +2
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. Disseminated Mycobacterium genavense presenting as recurrent steroid-responsive mesenteric lymphadenitis
    Portia Mira, Nancy L. Wengenack, Mary J. Kasten
    ASM case reportsPeer-reviewedCC BYFull textEpidemiology & public healthEurope PMCPMC
  4. Combined Vitamin B12 and Folate Deficiency Presenting As Pseudo-Thrombotic Microangiopathy With a Disseminated Intravascular Coagulation (DIC)-Like Coagulation Profile: A Case Report
    Moutaz W Sweileh, Hisham Asaad, Aya Abdi
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMCEurope PMCPMC
  5. Disseminated fusariosis presenting as intracranial bleeding in a heart transplant recipient
    Nour El Meski, Praveen Gundelly, Sree Sarah Cherian
    ASM case reportsPeer-reviewedCC BYFull textInfectious diseaseEurope PMCPMC

Cite

BibTeXRIS
BibTeX
@article{witkowska2026disseminated,
  title = {{Disseminated Ureaplasma urealyticum infection presenting as systemic inflammatory syndrome in ocrelizumab-treated patients with multiple sclerosis: a case series.}},
  author = {Anna Witkowska and Fionnuala Cahill and Killian O'Rourke and Padraig McGettrick and Tomás Burke and Geraldine McCarthy and Joanne Kitchen and Abdalla Abuelmagd and John Stack},
  journal = {Journal of medical case reports},
  year = {2026},
  month = jul,
  doi = {10.1186/s13256-026-06256-9},
  url = {https://europepmc.org/article/MED/42908024},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Disseminated Ureaplasma urealyticum infection presenting as systemic inflammatory syndrome in ocrelizumab-treated patients with multiple sclerosis: a case series.
AU  - Anna Witkowska
AU  - Fionnuala Cahill
AU  - Killian O'Rourke
AU  - Padraig McGettrick
AU  - Tomás Burke
AU  - Geraldine McCarthy
AU  - Joanne Kitchen
AU  - Abdalla Abuelmagd
AU  - John Stack
PY  - 2026
DA  - 2026/07/01
JO  - Journal of medical case reports
DO  - 10.1186/s13256-026-06256-9
UR  - https://europepmc.org/article/MED/42908024
AB  - Background  Ocrelizumab, an anti-CD20 monoclonal antibody, is widely used to treat multiple sclerosis (MS), inducing profound B-cell depletion and disease remission. However, it may rarely lead to opportunistic infections. We report two patients with MS on ocrelizumab who developed unique complications of anti-CD20 antibody therapy. One patient developed fulminant endophthalmitis, a novel complication that has not been previously reported.Case presentation  A 38-year-old female of South Asian descent and a 46-year-old White female, both with MS on ocrelizumab, developed disseminated Ureaplasma urealyticum infection which was initially misdiagnosed as reactive arthritis in both cases. Both patients deteriorated following immunosuppression, with one developing fulminant endophthalmitis. Diagnosis was established via broad-range PCR from synovial and ocular samples. Prolonged antimicrobial and glucocorticoid therapy led to resolution in both cases.Conclusions  Novel B-cell targeting agents can be effective treatments for MS; however, their use may be associated with potentially life-threatening complications. These two cases highlight the diagnostic and therapeutic challenges associated with opportunistic infections in the context of anti-CD20 monoclonal antibody therapy.
SN  - 1752-1947
ER  -