Persistent impaired immunity is possible even years after B-cell depleting therapies. This may favor the occurrence of infections, including infectious meningitis and encephalitis. In this study, we report a case of chronic enterovirus meningoencephalitis in prolonged B-cell depletion years after rituximab therapy.

This is a case report from a German academic hospital. In addition to repeated clinical examinations, repeated brain MRI and extended CSF and laboratory diagnostics were performed. We used the CARE checklist when writing our report.

A 38-year-old man presented with high fever (>40°C), severe headache, and progressive neurologic and cognitive deficits. As result of previous lymphoma therapy with rituximab years ago, prolonged B-cell aplasia was detected. To restore humoral immunity, the patient received repeated infusions of immunoglobulins. In the end, a complete restitution of the physical and mental condition was achieved with the established therapy.

This case report should emphasize the importance of assessing humoral immunity even years after B-cell depletion therapy, especially in case of opportunistic infections.

即使在 B 细胞耗竭治疗后数年，免疫力也可能持续受损。这可能有利于感染的发生，包括传染性脑膜炎和脑炎。在这项研究中，我们报告了一例在利妥昔单抗治疗后数年出现长期 B 细胞耗竭的慢性肠道病毒脑膜脑炎病例。

这是来自德国一家学术医院的病例报告。除了重复的临床检查外，还进行了重复的脑部 MRI 和扩展的脑脊液和实验室诊断。我们在撰写报告时使用了 CARE 检查表。

一名 38 岁男性出现高烧 (>40°C)、严重头痛以及进行性神经和认知缺陷。由于多年前使用利妥昔单抗治疗淋巴瘤，检测到长期 B 细胞再生障碍。为了恢复体液免疫，患者接受了反复输注免疫球蛋白。最终，通过既定的疗法，身体和精神状态都得到了彻底的恢复。

该病例报告应强调即使在 B 细胞耗竭治疗数年后评估体液免疫的重要性，特别是在机会性感染的情况下。