title: Molecular diagnosis of opportunistic pericardial infection in a patient treated with adalimumab: the role of next-generation sequencing.
abstract: Biological immune-modulator drugs, especially inhibitors of tumor necrosis factor-α, are frequently encountered in modern clinical practice and opportunistic infections are therefore a common concern. Infective pericarditis has been described as a complication of these treatments with possible life-threatening consequences. In similar cases cultures may isolate multiple opportunistic bacteria from the pericardial fluid without specific identification of the responsible germ, representing a problem for targeted antibiotic therapy. We present a case of acute pericarditis evolving in pericardial constriction and cardiac tamponade in a patient treated with adalimumab for psoriatic arthritis overlapping with recurrent polychondritis. Next-generation sequencing allowed the identification of a common oral pathogen as the aetiological agent confirming its role in the identification of species that can be overlooked by common microbiological techniques.
authors: Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy.
authors: Stefano
authors: http://orcid.org/0000-0003-4987-262X
authors: S
authors: Poli
authors: Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy Department of Medical Sciences, University of Trieste, Trieste, Italy.
authors: Manola
authors: M
authors: Comar
authors: Medical Specialties Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy.
authors: Roberto
authors: R
authors: Luzzati
authors: Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy.
authors: Gianfranco
authors: G
authors: Sinagra
mesh_terms: D000068879:Adalimumab / Q000009:adverse effects* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology; D010493:Pericarditis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D007155:Immunologic Factors; D000068879:Adalimumab