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[A case of acute and necrotizing cutaneous Mycobacterium marinum infection in a patient treated with infliximab for Crohn's disease].

AbstractBACKGROUND:
The increasing use of anti-TNFalpha exposes patients to emerging risks, particularly that of infection. We report a case of severe cutaneous Mycobacterium marinum infection in a patient treated with infliximab and we discuss therapeutic options.
PATIENTS AND METHODS:
A man treated with infliximab for Crohn's disease developed a severe cutaneous infection with M. marinum. Despite withdrawal of infliximab and the introduction of triple antibiotic therapy, the patient's lesions worsened and surgical treatment was required.
DISCUSSION:
The worsening experienced by our patient 1 week after the beginning of the treatment is comparable with the immune reconstitution syndrome occasionally observed in tuberculosis in immunocompromised hosts, thus raising the question of the potential value of continuing infliximab treatment. Recommendations are needed concerning the prevention and treatment of M. marinum infections in patients on anti-TNFalpha biotherapies.
AuthorsA Guyot, E Begon, L Abramowitz, J Landry, E Marinho, V Descamps, B Crickx
JournalAnnales de dermatologie et de venereologie (Ann Dermatol Venereol) Vol. 136 Issue 11 Pg. 806-10 (Nov 2009) ISSN: 0151-9638 [Print] France
Vernacular TitleInfection cutanée aiguë et nécrosante a Mycobacterium marinum chez un patient traité par infliximab pour une maladie de Crohn.
PMID19917434 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab
Topics
  • Anti-Bacterial Agents (therapeutic use)
  • Antibodies, Monoclonal (adverse effects, therapeutic use)
  • Crohn Disease (drug therapy)
  • Gastrointestinal Agents (adverse effects, therapeutic use)
  • Humans
  • Infliximab
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous (chemically induced, drug therapy, pathology, surgery)
  • Mycobacterium marinum
  • Necrosis
  • Skin Diseases, Bacterial (chemically induced, drug therapy, surgery)
  • Tumor Necrosis Factor-alpha (antagonists & inhibitors)

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