Cutaneous nocardiosis complicating management of Crohn's disease with infliximab and prednisone.
Infliximab is a chimeric anti-tumour necrosis factor-alpha antibody that is efficacious in treating Crohn's disease. However, its immunomodulatory properties increase susceptibility to opportunistic infections. We present a case of cutaneous Nocardia infection in a patient who was taking infliximab for Crohn's disease. The case illustrates the challenges in the diagnosis and management of this disease and serves as a reminder of the complications associated with the use of immunomodulatory agents.
Singh
Sheldon M
SM
Department of Medicine, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ont.
Rau
Neil V
NV
Cohen
Lawrence B
LB
Harris
Howard
H
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D001707:Biopsy, Needle; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D000069285:Infliximab; D007868:Leg Dermatoses / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000188:drug therapy / Q000209:etiology*; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology
D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab; D011241:Prednisone