{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:52:31Z","timestamp":1790815951364,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T00:00:00Z","timestamp":1658016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Enterovirus infections pose a serious threat for patients with humoral deficiencies and may be lethal, whilst the efficacy of proposed treatment options such as corticosteroids, intravenous immunoglobulins and fluoxetine remains debated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Viral clearance was investigated in a patient with rituximab\u2010induced B\u2010cell depletion and chronic echovirus 13 (E13) meningoencephalitis\/myofasciitis in response to intravenous immunoglobulins and fluoxetine using sequential semi\u2010quantitative E13 viral load measurements by real\u2010time reverse transcription polymerase chain reaction. Fluoxetine concentrations in plasma and cerebrospinal fluid were determined by liquid chromatography mass spectrometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intravenous immunoglobulins appeared ineffective in this case of E13 infection, whereas virus clearance in cerebrospinal fluid was obtained after 167\u2009days of oral fluoxetine. Since treatment with corticosteroids resulted in a flare of symptoms, rechallenge with viral load measurements was not attempted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this report of a patient with rituximab\u2010associated chronic echovirus 13 meningoencephalitis, viral clearance in response to single treatment options is assessed for the first time. Our observations further support the <jats:italic>in vivo<\/jats:italic> efficacy of fluoxetine against enteroviral infections. More research is needed to establish its efficacy in different enterovirus strains.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15478","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T20:18:56Z","timestamp":1656447536000},"page":"3117-3123","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Antiviral treatment with fluoxetine for rituximab\u2010associated chronic echovirus 13 meningoencephalitis and myofasciitis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7367-3060","authenticated-orcid":false,"given":"Ga\u00ebl","family":"Vermeersch","sequence":"first","affiliation":[{"name":"Department of General Medical Oncology University Hospitals Leuven, Leuven Cancer Institute, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9118-8608","authenticated-orcid":false,"given":"Lies","family":"Laenen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, National Reference Centre for Enteroviruses University Hospitals Leuven, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9raldine","family":"Lens","sequence":"additional","affiliation":[{"name":"Department of General Medical Oncology University Hospitals Leuven, Leuven Cancer Institute, KU Leuven  Leuven Belgium"},{"name":"Department of Nuclear Medicine University Hospitals Leuven, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4061-0722","authenticated-orcid":false,"given":"Kim C. M.","family":"van der Elst","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Division Laboratories, Pharmacy and Biomedical Genetics University Medical Centre Utrecht, Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar Rudolf","family":"Thal","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals Leuven, and Laboratory of Neuropathology, Department of Imaging and Pathology Leuven Brain Institute, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-9078","authenticated-orcid":false,"given":"Sander","family":"Jentjens","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine University Hospitals Leuven, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Demaerel","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospitals Leuven, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0898-904X","authenticated-orcid":false,"given":"Tine","family":"Van Nieuwenhuyse","sequence":"additional","affiliation":[{"name":"Pharmacy Department University Hospitals Leuven, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Wollants","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology Rega Institute, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Boeckx","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine University Hospitals Leuven, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Verhaert","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery University Hospitals Leuven, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedicte","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospitals Leuven, Leuven Brain Institute, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J. 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