title: A case of opportunistic skin infection with Mycobacterium marinum during adalimumab treatment in a patient with Crohn's disease.
abstract: Opportunistic infections, especially reactivation with M. tuberculosis, are major complications during treatment with anti-TNF agents. Infections with atypical mycobacteria like Mycobacterium marinum are rare and tend to turn into a difficult and prolonged course due to delayed diagnosis. This is the first case of M. marinum infection during adalimumab therapy in a patient with Crohn's disease. The most important diagnostic step was a detailed medical history as PCR tested for M. tuberculosis and for atypical subspecies was false negative. Up to now a discontinuation of anti-TNF therapy has been recommended, however, there is no consensus about the reintroduction of biologicals after sufficient anti-infective therapy. In this patient anti-TNF therapy had to be reintroduced because of increasing activity with no relapse of M. marinum after a follow-up of 12 months.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Austria.
authors: Patrizia K
authors: PK
authors: Kump
authors: Christoph
authors: C
authors: Högenauer
authors: Heimo H
authors: HH
authors: Wenzl
authors: Wolfgang
authors: W
authors: Petritsch
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D019910:Mycobacterium marinum; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D017192:Skin Diseases, Bacterial / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D000995:Antitubercular Agents; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab