title: A case of legionellosis during treatment with a TNFalpha antagonist.
abstract: We report a patient with Legionella pneumophila pneumonia after infliximab therapy for rheumatoid arthritis. Arguments are discussed for an emerging incidence of infections with intracellular microorganisms, granulomatous and non-granulomatous, in patients having received anti-TNFalpha therapy. These discussions consist of clinical and epidemiological data, experimental data in animals, theoretical evidence, and we provide a possible pathogenetic mechanism.
authors.affiliation: Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Marielle J
authors.initials: MJ
authors.lastname: Wondergem
authors.forename: Alexandre E
authors.initials: AE
authors.lastname: Voskuyl
authors.forename: Michiel A
authors.initials: MA
authors.lastname: van Agtmael
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D016952:Legionella pneumophila; D007877:Legionnaires' Disease / Q000209:etiology* / Q000382:microbiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab