title: Pulmonary actinomycosis complicating infliximab therapy for Crohn disease.
abstract: The use of anti-tumour necrosis factor (TNF) agents has expanded significantly over the past few years, particularly for rheumatological diseases and Crohn disease. A number of associated opportunistic infections have been observed as a result of suppression of T-cell-mediated immunity, the most frequent being tuberculosis. This report describes a case of pulmonary actinomycosis in a 52-year-old patient receiving regular infusions of infliximab, an anti-TNF agent, for Crohn disease. He presented with a 12-day history of fever, night sweats and a non-productive cough on a background of a 9-year history of Crohn terminal ileitis. There was radiological evidence of a left upper lobe non-cavitatory pneumonia and bronchoscopic lavage fluid eventually grew Actinomyces graevenitzii. The patient was hospitalised and improved with antibiotic therapy. Within 4 weeks there was almost complete radiological resolution and infliximab was restarted after 4 months without further complication.
authors.affiliation: Departments of Medicine and Pathology, University of British Columbia, Vancouver, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Cohen
authors.forename: William
authors.initials: W
authors.lastname: Bowie
authors.forename: Robert
authors.initials: R
authors.lastname: Enns
authors.forename: Julia
authors.initials: J
authors.lastname: Flint
authors.forename: Mark
authors.initials: M
authors.lastname: Fitzgerald