Risk of nocardial infections with anti-tumor necrosis factor therapy

Am J Med Sci. 2013 Aug;346(2):166-8. doi: 10.1097/MAJ.0b013e3182883708.

Abstract

Anti-tumor necrosis factor (anti-TNF) therapy is beneficial in the management of many chronic immune-mediated inflammatory diseases. However, its use is associated with increased risk of bacterial, fungal and viral infections. We present a case of cutaneous nocardiosis that occurred in a 61-year-old man, whose Crohn's disease was treated for nearly 1.5 years with infliximab. Prompt therapy with trimethoprim-sulfamethoxazole led to complete resolution. Only few cases of nocardiosis complicating anti-TNF therapy are reported in the literature. We present the case report and summary of the available literature with updates on the management and the treatment of the disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Infliximab
  • Male
  • Middle Aged
  • Nocardia / isolation & purification*
  • Nocardia Infections / drug therapy
  • Nocardia Infections / etiology*
  • Nocardia Infections / microbiology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Antibodies, Monoclonal
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab