Miliary tuberculosis following infliximab therapy for Crohn disease: A case report and review of the literature.
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.
Stas
P
P
Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
D'Hoore
A
A
Van Assche
G
G
Geboes
K
K
Steenkiste
E
E
Penninckx
F
F
Rutgeerts
P
P
Vermeire
S
S
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*
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab