title: A case of Brucella spondylitis in a patient with psoriatic arthritis receiving infliximab.
abstract: 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.
authors.affiliation: Rheumatology Clinic, Department of Internal Medicine, University of Ioannina, Greece.
authors.forename: C E
authors.initials: CE
authors.lastname: Papagoras
authors.forename: M I
authors.initials: MI
authors.lastname: Argyropoulou
authors.forename: P V
authors.initials: PV
authors.lastname: Voulgari
authors.forename: I
authors.initials: I
authors.lastname: Vrabie
authors.forename: A K
authors.initials: AK
authors.lastname: Zikou
authors.forename: A A
authors.initials: AA
authors.lastname: Drosos