title: Mycobacterium fortuitum infection following adalimumab treatment for psoriasis and subsequent complication-free treatment with alternate TNF-a blockers.
abstract: Tumor necrosis factor-a (TNF-a) inhibitors, such as adalimumab, are often used to treat psoriasis and psoriatic arthritis. While it is well known that these agents increase the risk of reactivation tuberculosis, recent evidence suggests that the risk of other nontuberculous mycobacterial (NTM) infections is on the rise. We report cutaneous Mycobacterium fortuitum in a 60-year-old woman with psoriasis who had been receiving adalimumab therapy for psoriatic arthritis for six months. No other risk factors were identified. M. fortuitum was cultured from a lesion on the right leg. Following resolution of the lesion, the patient has been successfully treated with infliximab infusions and subsequently certalizumab without complication for the past three years. To our knowledge, this is the first report of M. fortuitum occurring in a patient receiving adalimumab with successful subsequent treatment without complication while on another TNF-a inhibitor.
authors.affiliation: Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Chang
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Sri
authors.forename: Marcia
authors.initials: M
authors.lastname: Driscoll
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Gaspari
mesh_terms: D000068879:Adalimumab; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000068582:Certolizumab Pegol; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy; D019907:Mycobacterium fortuitum / Q000187:drug effects*; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D018124:Receptors, Tumor Necrosis Factor / Q000037:antagonists & inhibitors*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D007140:Immunoglobulin Fab Fragments; D018124:Receptors, Tumor Necrosis Factor; D011092:Polyethylene Glycols; D000068879:Adalimumab; D000068582:Certolizumab Pegol