A case of Brucella spondylitis in a patient with psoriatic arthritis receiving infliximab

A 69-year-old woman with psoriatic arthritis treated with infliximab presented with low back pain of recent onset and fever. Serological, microbiological and imaging studies revealed Brucella spondylitis at the L5-S1 level. Immunosuppressive therapy was suspended and antibiotic therapy including dox...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2009, Vol.27 (1), p.124-127
Main Authors: PAPAGORAS, C. E, ARGYROPOULOU, M. I, VOULGARI, P. V, VRABIE, I, ZIKOU, A. K, DROSOS, A. A
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - therapeutic use
Antibodies, Monoclonal - adverse effects
Arthritis, Psoriatic - drug therapy
Biological and medical sciences
Brucellosis - diagnosis
Brucellosis - drug therapy
Brucellosis - immunology
Dermatology
Diseases of the osteoarticular system
Diseases of the spine
Doxycycline - therapeutic use
Drug Therapy, Combination
Female
Humans
Immunity, Innate - immunology
Inflammatory joint diseases
Infliximab
Medical sciences
Psoriasis. Parapsoriasis. Lichen
Rifampin - therapeutic use
Spondylitis - microbiology
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Tumor Necrosis Factor-alpha - immunology
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Summary:A 69-year-old woman with psoriatic arthritis treated with infliximab presented with low back pain of recent onset and fever. Serological, microbiological and imaging studies revealed Brucella spondylitis at the L5-S1 level. Immunosuppressive therapy was suspended and antibiotic therapy including doxycycline and rifampicin was administered for six months. The patient responded adequately with clinical and laboratory improvement and a considerable remission of spondylitis on repeat magnetic resonance imaging scan. The pathophysiology of tumor necrosis factor (TNF) alpha in Brucellosis and the role of anti-TNFalpha therapy are discussed.
ISSN:0392-856X
1593-098X