title: Miliary tuberculosis following infliximab therapy for Crohn disease: A case report and review of the literature.
abstract: We present a case of miliary tuberculosis diagnosed 15 months after infliximab treatment despite negative screening for previous exposure to Mycobacteria on skin PPD and chest X-ray. This case shows that--although screening for TB with a skin PPD and a chest X-ray should be performed in all patients--this is not 100% effective and may be a problem in patients on concomitant immunosuppression. The clinical course of this patient further shows that in a patient treated with anti-TNF antibodies who's condition does not improve one should always be aware of the possibility of a tuberculosis infection. Even though tuberculosis is usually not rapidly fatal, the disease may show a fulminant course in immunocompromised patients.
authors.affiliation: Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Stas
authors.forename: A
authors.initials: A
authors.lastname: D'Hoore
authors.forename: G
authors.initials: G
authors.lastname: Van Assche
authors.forename: K
authors.initials: K
authors.lastname: Geboes
authors.forename: E
authors.initials: E
authors.lastname: Steenkiste
authors.forename: F
authors.initials: F
authors.lastname: Penninckx
authors.forename: P
authors.initials: P
authors.lastname: Rutgeerts
authors.forename: S
authors.initials: S
authors.lastname: Vermeire
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D000069285:Infliximab; D008297:Male; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology*; D014391:Tuberculosis, Miliary / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab