Rapid growing mycobacteria and TNF-alpha blockers: case report of a fatal lung infection with Mycobacterium abscessus in a patient treated with infliximab, and literature review.

摘要

Rapid growing mycobacteria pose as a serious emerging threat for patients treated with TNF-alpha blockers. We report a case of a progressive and fatal pulmonary infection with M. abscessus in a patient previously treated with infliximab for Crohn's disease and review seven other previously reported patients. Five out of eight patients were female. The patients were treated with either anti-TNF-alpha antibodies or TNF-alpha blocking receptor. The diagnosis of RGM came in the first 6 months after initiation of TNF-alpha blockers in five out eight patients. The two patients with M. abscessus lung infection died in spite of antibiotic treatment, whereas the other patients with skin affection and lever affection due to M. Fortuitum had a resolution of their symptoms with discontinuation of TNF-alpha blockers and antibiotics.