Nocardiosis in a patient with rheumatoid athritis treated with rituximab and a summary of reported cases

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Abstract

Rituximab is a B-cell-depleting monoclonal anti-CD20 antibody. It is widely used in haematology and rheumatology. However, usage of rituximab in immunosupressed patient has been associated with various opportunistic infections. The authors reported a case of refractory rheumatoid arthritis treated with rituximab, which later presented with non-resolving pneumonia with pulmonary nodule. Percutaneous computer tomogram guided lung biopsy was arranged to confirm the suspicion of tuberculosis, but did not yield conclusive results. Later, she presented left-chest abscess and underwent incision and drainage. The pus culture and sensitivity confirmed pulmonary nocardiosis with chest wall dissemination. She was treated with 2-week course of trimethoprim sulfamethoxazole and responded. The authors also reviewed published cases of nocardiosis post-rituximab.

Original languageEnglish
JournalBMJ Case Reports
DOIs
Publication statusPublished - 29 Sep 2010

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Nocardia Infections
Lung
Suppuration
Opportunistic Infections
Sulfamethoxazole Drug Combination Trimethoprim
Rheumatology
Thoracic Wall
Hematology
Abscess
Drainage
Anti-Idiotypic Antibodies
Rheumatoid Arthritis
Pneumonia
Tuberculosis
B-Lymphocytes
Thorax
Monoclonal Antibodies
Biopsy
Rituximab

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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abstract = "Rituximab is a B-cell-depleting monoclonal anti-CD20 antibody. It is widely used in haematology and rheumatology. However, usage of rituximab in immunosupressed patient has been associated with various opportunistic infections. The authors reported a case of refractory rheumatoid arthritis treated with rituximab, which later presented with non-resolving pneumonia with pulmonary nodule. Percutaneous computer tomogram guided lung biopsy was arranged to confirm the suspicion of tuberculosis, but did not yield conclusive results. Later, she presented left-chest abscess and underwent incision and drainage. The pus culture and sensitivity confirmed pulmonary nocardiosis with chest wall dissemination. She was treated with 2-week course of trimethoprim sulfamethoxazole and responded. The authors also reviewed published cases of nocardiosis post-rituximab.",
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AU - Low, S. F.

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