Orbital cellulitis in a patient receiving infliximab for Ankylosing spondylitis.
OBJECTIVE
To describe a case of orbital cellulitis arising in a patient treated with an anti-TNFalpha agent.


METHODS
Single interventional case report.


METHODS
A 42-year-old man developed severe unilateral orbital cellulitis while receiving infliximab (Remicade, Centocor) treatment for Ankylosing spondylitis (AS) as part of the open-label phase of a trial conducted at our tertiary referral center. Cultures grew Staphylococcus aureus.


RESULTS
Infliximab treatment was stopped and the patient made a full recovery after receiving appropriate antibiotic therapy. Infliximab therapy was resumed after three weeks.


CONCLUSIONS
Clinical vigilance is warranted when treating patients with anti-TNFalpha agents as these are associated with a diverse and growing number of ophthalmic complications. Resolved infection does not preclude the use of such agents.
Department of Medicine, University of Cambridge, Cambridge, United Kingdom. jcpr2@cam.ac.uk
Jonathan C P
JC
Roos
Andrew J K
AJ
Ostor
D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D002439:Cefotaxime / Q000627:therapeutic use; D002481:Cellulitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008826:Microbial Sensitivity Tests; D009916:Orbital Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D019980:Amoxicillin-Potassium Clavulanate Combination; D000069285:Infliximab; D002439:Cefotaxime