Pneumonia due to Nocardia cyriacigeorgica in a patient with Crohn's disease treated with infliximab

Parra, ME; Martinez, M.; Remacha, María Antonia; Sáez-Nieto, Juan Antonio; García, Encarnación; Yagüe, Genoveva; Guardiola, Jordi

doi:10.1016/j.crohns.2008.05.003

Cited by 10 publications

(2 citation statements)

References 11 publications

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“…2018;9(2):68-72 therapy. As reviewed, there are 10 cases described in literature, all under anti-TNF therapy [22][23][24][25][26][27][28][29][30][31]. To our knowledge, this is the first described case of nocardiosis in a patient under TCZ.…”

Section: Discussionmentioning

confidence: 91%

Cerebral Nocardiosis in a Patient With Rheumatoid Arthritis Under Treatment With Tocilizumab

et al. 2018

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The use of biological therapy has revolutionized the treatment of various autoimmune diseases. Tocilizumab (TCZ) is a recombinant humanized antiinterleukin-6 (IL-6) receptor monoclonal antibody approved for the treatment of patients with rheumatoid arthritis, as monotherapy or in combination with other disease-modifying antirheumatic drugs (DMARDs). Clinical and post-marketing surveillance studies of TCZ indicate that infections are the most frequent adverse events. Most of the serious infections described are bacterial and viral, with no uncommon pathogens. The authors report a case of a patient with destructive rheumatoid arthritis under TCZ that presented with neurological symptoms and a right cerebellar lesion with marked diffusion restriction suggestive of cerebellar abscess. The microbiologic studies from aspirative cerebral biopsy revealed Nocardia farcinica. With adequate antibiotics, the patient evolved with resolution of all symptoms and brain abscess at 5 months of followup. According to published reports, this is the first case of nocardial infection in patients under TCZ. The case highlights the importance of being aware of risk infection in these patients and need of an early diagnosis allowing a prompt treatment.

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Section: Discussionmentioning

confidence: 91%

Cerebral Nocardiosis in a Patient With Rheumatoid Arthritis Under Treatment With Tocilizumab

et al. 2018

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“…[16][17][18] Combination therapy of 2 or more agents may be warranted in severe systemic or CNS infections. 19,20 Systemic infection (lungs, skin and brain) 75-year-old man (RA) 9 Adalimumab Corticosteroids Lungs 70-year-old man (RA) 6 Infliximab Methotrexate, corticosteroids Skin 53-year-old woman (Crohn's disease) 10 Infliximab Mesalamine, azathioprine, corticosteroids Lungs 66-year-old woman (psoriasis) 4 Infliximab Alefacept Adrenal glands 45-year-old man (Crohn's disease) 11 Infliximab Budesonide, mesalamine, prednisone Skin 77-year-old woman (Crohn's disease) 12 Infliximab Methylprednisolone, azathioprine Lungs a References are indicated by superscript numbers after the case description. RA, rheumatoid arthritis; TMP-SMZ, trimethoprim-sulfamethoxazole.…”

Section: Casementioning

confidence: 99%