Necrotising fasciitis in a patient receiving infliximab for rheumatoid arthritis.
A case of necrotising fasciitis in a patient receiving infliximab, an antitumour necrosis factor alpha (TNF-alpha) agent for rheumatoid arthritis, is presented. A widespread confluent, erythematous, pustular skin rash was the presenting sign. There was no fever throughout this admission. beta-Haemolytic group A streptococcus was isolated from blood cultures and skin swabs. The adductor muscles and fascia around the site of a previous hip arthroplasty were necrotic on exploration. The case highlights the risk of severe sepsis in patients on anti-TNF-alpha treatment.
Chan
A T Y
AT
Rheumatology Department, Sunderland Royal Hospital, Sunderland, UK. antonichan@hotmail.com
Cleeve
V
V
Daymond
T J
TJ
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D003875:Drug Eruptions / Q000209:etiology; D004359:Drug Therapy, Combination; D019115:Fasciitis, Necrotizing / Q000139:chemically induced*; D017809:Fatal Outcome; D006801:Humans; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab; D008727:Methotrexate