title: Salmonella enterica arthritis in a patient with rheumatoid arthritis receiving anti-tumour necrosis factor therapy.
abstract: Anti-tumour necrosis factor (TNF) monoclonal antibodies have become an invaluable treatment against chronic inflammatory diseases such as rheumatoid arthritis (RA). However, due to increased risk of opportunistic infections, patients receiving anti-TNF therapy should be closely monitored for serious infections. Here, we describe a case of acute Salmonella_enteritidis infection of a joint arthroplasty that previously was functioning well, in a patient receiving infliximab treatment for RA. After prolonged antimicrobial chemotherapy and interrupted infliximab treatment, reimplantation of a new prosthesis was successfully performed two years after Salmonella septic arthritis. Therefore, because of the possibility of extraintestinal salmonellosis, screening for fecal colonization could be advisable in patients undergoing anti-TNF treatment. Moreover we emphasize the importance of appropriate counselling of these patients concerning food hygiene.
authors.affiliation: Department of Clinical Microbiology, University Hospital Rijeka, Rijeka, Croatia. marina.bubonja@medri.uniri.hr
authors.forename: M
authors.initials: M
authors.lastname: Bubonja-Sonje
authors.affiliation: Lovran Clinic for Orthopaedic Surgery, Lovran, Croatia.
authors.forename: D
authors.initials: D
authors.lastname: Rubinic
authors.affiliation: Department of Internal Medicine, University Hospital Rijeka, Rijeka, Croatia.
authors.forename: F
authors.initials: F
authors.lastname: Anic
authors.affiliation: Department of Internal Medicine, University Hospital Rijeka, Rijeka, Croatia.
authors.forename: S
authors.initials: S
authors.lastname: Novak
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
authors.forename: D
authors.initials: D
authors.lastname: Vuckovic
authors.affiliation: Department of Clinical Microbiology, University Hospital Rijeka, Rijeka, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Abram
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001170:Arthritis, Infectious / Q000150:complications / Q000276:immunology*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D000069285:Infliximab; D007720:Knee Prosthesis; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000150:complications / Q000276:immunology*; D012480:Salmonella Infections / Q000150:complications / Q000276:immunology*; D019779:Salmonella enterica; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab