A Case of Nocardiosis in a Patient with Ulcerative Colitis on Chronic Corticosteroids and Treated with Upadacitinib

Abstract

The immunosuppressive effects of treatment for ulcerative colitis, including chronic corticosteroids, anti-TNF agents, and JAK inhibitors, can impact the spread of latent or obscure infections. Clinicians should have low thresholds for aggressive diagnostic and therapeutic intervention if patients show signs of clinical deterioration while on upadacitinib. Our unique case highlights an immunosuppressed patient with ulcerative colitis who developed Nocardiosis after initiation of upadacitinib while hospitalized for concurrent UC flare and C. difficile infection.