A case of Brucella spondylitis in a patient with psoriatic arthritis receiving infliximab.
A 69-year-old woman with psoriatic arthritis treated with infliximab presented with low back pain of recent onset and fever. Serological, microbiological and imaging studies revealed Brucella spondylitis at the L5-S1 level. Immunosuppressive therapy was suspended and antibiotic therapy including doxycycline and rifampicin was administered for six months. The patient responded adequately with clinical and laboratory improvement and a considerable remission of spondylitis on repeat magnetic resonance imaging scan. The pathophysiology of tumor necrosis factor (TNF) alpha in Brucellosis and the role of anti-TNFalpha therapy are discussed.
Papagoras
C E
CE
Rheumatology Clinic, Department of Internal Medicine, University of Ioannina, Greece.
Argyropoulou
M I
MI
Voulgari
P V
PV
Vrabie
I
I
Zikou
A K
AK
Drosos
A A
AA