Salmonella enterica arthritis in a patient with rheumatoid arthritis receiving anti-tumour necrosis factor therapy

West Indian Med J. 2013 Mar;62(3):270-2.

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.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antirheumatic Agents / adverse effects*
  • Arthritis, Infectious / complications
  • Arthritis, Infectious / immunology*
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy*
  • Arthroplasty, Replacement, Knee
  • Female
  • Humans
  • Immunocompromised Host*
  • Infliximab
  • Knee Prosthesis
  • Middle Aged
  • Prosthesis-Related Infections / complications
  • Prosthesis-Related Infections / immunology*
  • Salmonella Infections / complications
  • Salmonella Infections / immunology*
  • Salmonella enterica*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tumor Necrosis Factor-alpha / immunology

Substances

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