title: [Legionella pneumonia after infliximab in a patient with rheumatoid arthritis].
abstract: The antagonists of tumour necrosis factor (anti-TNF) have been successfully used in several chronic inflammatory diseases such as Rheumatoid Arthritis (RA), but some studies have observed the development of infections by intracellular pathogens in patients using anti-TNF. We report a case of a female patient with previous diagnosis of RA for 16 years that used several disease-modifying anti-rheumatic drugs (DMARDs) that resulted in treatment failure, and then was treated with infliximab. After fifteen days of the second dose, the patient developed ventilatory-dependent chest pain, dry cough and dyspnea. She was hospitalized, and the diagnosis of pneumonia by Legionella pneumophila was confirmed by the presence of Legionella antigen in an urine test. TNF is an inflammatory cytokine that also acts inhibiting the bacterial growth of intracellular pathogens, and its inhibition seems to increase susceptibility to these infections in some patients.
authors: Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
authors: Karina de Souza
authors: Kde S
authors: Giassi
authors: Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
authors: Vilson
authors: V
authors: Furlanetto
authors: Núcleo de Reumatologia, Hospital Universitário Polydoro Ernani de São Thiago, Florianópolis, SC, Brasil.
authors: Sonia
authors: S
authors: Fialho
authors: Núcleo de Reumatologia, Hospital Universitário Polydoro Ernani de São Thiago, Florianópolis, SC, Brasil.
authors: Giovana
authors: G
authors: Gomes Ribeiro
authors: Núcleo de Reumatologia, Hospital Universitário Polydoro Ernani de São Thiago, Florianópolis, SC, Brasil. Electronic address: ivaniop@matrix.com.br.
authors: Ivânio Alves
authors: IA
authors: Pereira
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000009:adverse effects* / Q000627:therapeutic use; D007877:Legionnaires' Disease / Q000139:chemically induced*; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
keywords: Artrite reumatoide; Fator alpha de necrose por tumor; Infliximab; Infliximabe; Legionella pneumophila; Rheumatoid arthritis; Tumour necrosis factor alpha