Table 2.

Clinical symptoms and CSF findings in case 1.

Days After Last Alemtuzumab Infusion	Symptoms	Findings	Treatment
d1	Subfebrile temperatures, progressive cephalgia	-	-
d3	Fever (40.1 °C, 104 °F), cephalgia, neck stiffness, photophobia, worsening of preexisiting MS symptoms	CSF analysis: Cell count: 459 leukocytes/µL (predominantly neutrophils) Protein: 0.966 g/L (normal range 0.080–0.45 g/L) Lactate: 7.4 mmol/L (normal range 1.2–2.1) Intrathecal IgM synthesis CSF cultures: Listeria monocytogenes positive Cranial MRI: 2 new contrast-enhancing lesions	After positive cultures for Listeria monocytogenes in CSF: ampicillin for 21 days
d17	Free of complaints	CSF analysis: Cell count: 20 leukocytes/µL Protein: 0.444 g/L Lactate: 2.14 mmol/L	Ampicillin continued