Listeria monocytogenes infection associated with methotrexate treatment for a patient with rheumatoid arthritis

Abstract

A 61-year-old women had been treated with methotrexate (MTX) since May 1993 for rheumatoid arthritis. She developed a high fever on 1 July 1997 and was diagnosed as having Listeria monocytogenes sepsis and meningoencephalitis. The encephalitis progressed inexorably and she died on 12 July. Although MTX is used as a first-line disease modifying anti- rheumatic drug, listeriosis should be remembered as a potentially fatal adverse effect.