Rare infection in patient with rheumatoid arthritis treated with adalimumab

BMJ Case Rep. 2019 Nov 21;12(11):e230871. doi: 10.1136/bcr-2019-230871.

Abstract

Mycobacterium haemophilum is a rare pathogen, predominately present in the immunocompromised population. It is especially studied in HIV and haematological malignancy patients. Given its unique living conditions, it is often difficult to establish its diagnosis, but it is often suspected by its classic association with ulcerating skin findings. Our case is unique in that our patient is immunocompromised by his rheumatoid arthritis treatment, and presented without any skin lesions, but was found to have this rare pathogen causing a constellation of unusual symptoms.

Keywords: infections; malignant disease and immunosuppression; rheumatoid arthritis; rheumatology.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab / therapeutic use
  • Adult
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / immunology*
  • Diagnosis, Differential
  • Humans
  • Immunocompromised Host*
  • Lymph Nodes / pathology
  • Male
  • Mediastinal Diseases / complications
  • Mediastinal Diseases / diagnosis*
  • Mediastinal Diseases / diagnostic imaging
  • Mediastinal Diseases / drug therapy
  • Mycobacterium Infections / complications
  • Mycobacterium Infections / diagnosis*
  • Mycobacterium Infections / diagnostic imaging
  • Mycobacterium Infections / drug therapy
  • Mycobacterium haemophilum*

Substances

  • Antirheumatic Agents
  • Adalimumab