University Hospital North Norway, Rheumatology, Tromsø, Norway.
Clin Exp Rheumatol. 2011 Jul-Aug;29(4):705-7. Epub 2011 Sep 1.
Rapid growing mycobacteria pose as a serious emerging threat for patients treated with TNF-α 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-α antibodies or TNF-α blocking receptor. The diagnosis of RGM came in the first 6 months after initiation of TNF-α 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-α blockers and antibiotics.
快速生长的分枝杆菌对接受 TNF-α 阻滞剂治疗的患者构成严重的新兴威胁。我们报告了一例先前接受英夫利昔单抗治疗克罗恩病的患者发生进行性和致命性肺脓肿分枝杆菌感染的病例，并回顾了其他七例先前报道的患者。8 例患者中有 5 例为女性。这些患者接受了抗 TNF-α 抗体或 TNF-α 阻断受体治疗。在 8 例患者中，有 5 例在开始使用 TNF-α 阻滞剂后的 6 个月内诊断出快速生长分枝杆菌。2 例患有脓肿分枝杆菌肺部感染的患者尽管接受了抗生素治疗仍死亡，而其他 2 例因偶然分枝杆菌引起皮肤和肝脏感染的患者在停用 TNF-α 阻滞剂和抗生素后症状得到缓解。
