title: Multidrug resistant miliary tuberculosis during infliximab therapy despite tuberculosis screening.
abstract: We describe an unusual case of multidrug-resistant miliary tuberculosis diagnosed 9 months after the commencement of infliximab treatment for psoriasis despite negative pretreatment tuberculosis screening, including chest X-ray and interferon-gamma release assay. After 4 months' treatment with amikacin, ethambutol, pyrazinamide and moxifloxacin, infliximab was restarted with concomitant anti-TB medications. No recurrence of tuberculosis has been detected 12 months after recommencing infliximab.
authors.affiliation: Department of Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gin
authors.forename: Con
authors.initials: C
authors.lastname: Dolianitis
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy; D005188:False Negative Reactions; D006801:Humans; D000069285:Infliximab; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014391:Tuberculosis, Miliary / Q000188:drug therapy / Q000209:etiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000209:etiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D000995:Antitubercular Agents; D000069285:Infliximab
keywords: biologics; infliximab; miliary; multidrug resistant; psoriasis; tuberculosis