Abstract
Reactivation of Bovine Tuberculosis in Patient Treated with Infliximab, Switzerland
Highlights
We describe a case of peritoneal TB, probably resulting from reactivation of Mycobacterium bovis infection after infliximab treatment
On November 30, 2007, she was given prednisone (40 mg/d for 2 weeks, tapered) and prescribed 3 doses of infliximab because of severe inflammation seen during colonoscopy (5 mg/kg on November 30, 2007, January 4, 2008, and February 15, 2008). She was hospitalized on April 25, 2008, at which time she had ascites; the fluid contained 1.4 × 109/L leukocytes (79.5% lymphocytes) but was negative for acid-fast bacilli on direct examination and PCR testing for Mycobacterium tuberculosis complex
In January 2009, she was much improved after treatment with isoniazid/rifampin/ ethambutol for 3 months and moxifloxacin/rifampin for 5 months. This case of presumed reactivation of peritoneal TB caused by M. bovis in a patient treated with infliximab highlights the need to be aware of local epidemiology with regard to transmissible infectious diseases
Summary
Reactivation of Bovine Tuberculosis in Patient Treated with Infliximab, Switzerland We describe a case of peritoneal TB, probably resulting from reactivation of Mycobacterium bovis infection after infliximab treatment. In November 2007, during a recurrence of Crohn disease and while receiving treatment with azathioprine, the patient had a negative interferon gamma release assay (IGRA) result (QuantiFERON-TB in Tube test; Cellestis International, Carnegie, Victoria, Australia) and an unremarkable chest radiograph.
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