Multiple streptococcal brain abscesses in a patient taking Secukinumab

The approval of the IL-17A inhibitor Secukinumab (Cosentyx; Novartis International, King of Prussia, Pennsylvania) was a major advance in psoriasis treatment, with most patients experiencing a 75% reduction in severity1. Known side effects include an increase in minor infections, but no major infectious adverse events and no nervous system involvement1–4, leading to broad use and an increase in clinical trials targeting the IL-17 pathway. Here, we describe a patient on Secukinumab who presented with severe neurologic deficits due to multifocal brain lesions. These were found to be disseminated streptococcal infection, and resolved after antibiotic treatment.