Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab.
Identifieur interne : 000721 ( Ncbi/Merge ); précédent : 000720; suivant : 000722Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab.
Auteurs : Mai T T. Nguyen [Danemark] ; Jan P Denphant ; Pernille RavnSource :
- BMJ case reports [ 1757-790X ] ; 2013.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Anticorps monoclonaux humanisés, Antirhumatismaux.
- Adulte d'âge moyen, Femelle, Humains, Indice de gravité médicale, Infections à staphylocoques, Mâle, Sujet âgé.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Antibodies, Monoclonal, Humanized, Antirheumatic Agents.
- chemically induced : Staphylococcal Infections.
- Aged, Female, Humans, Male, Middle Aged, Severity of Illness Index.
Abstract
We report three cases of severe disseminated Staphylococcus aureus infection in patients with rheumatoid arthritis (RA) treated with tocilizumab. Tocilizumab is a new drug, unknown to most internists, and injections given weeks before admission may not be considered by the patient as part of their 'current medical treatment', and the physician may not be aware that the patient is severely immunosuppressed. Severe infections in RA patients treated with tocilizumab may present with mild symptoms despite severe and disseminated infection and, as these patients are severely immunodeficient-intensive diagnostic work-up and early treatment should be performed. Systematic postmarketing studies are needed to clarify if there is a true increased risk of disseminated S aureus infections. We suggest caution when prescribing tocilizumab to patients with prosthetic joints and/or prior invasive S aureus infections and that patients are taught to inform health staff about their medication history and their increased risk of infection.
DOI: 10.1136/bcr-2012-007413
PubMed: 23283607
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Nguyen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, University Hospital, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Infectious Diseases, University Hospital, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author><author><name sortKey="P Denphant, Jan" sort="P Denphant, Jan" uniqKey="P Denphant J" first="Jan" last="P Denphant">Jan P Denphant</name></author><author><name sortKey="Ravn, Pernille" sort="Ravn, Pernille" uniqKey="Ravn P" first="Pernille" last="Ravn">Pernille Ravn</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23283607</idno><idno type="pmid">23283607</idno><idno type="doi">10.1136/bcr-2012-007413</idno><idno type="wicri:Area/PubMed/Corpus">001745</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001745</idno><idno type="wicri:Area/PubMed/Curation">001745</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001745</idno><idno type="wicri:Area/PubMed/Checkpoint">001487</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001487</idno><idno type="wicri:Area/Ncbi/Merge">000721</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab.</title><author><name sortKey="Nguyen, Mai T T" sort="Nguyen, Mai T T" uniqKey="Nguyen M" first="Mai T T" last="Nguyen">Mai T T. Nguyen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, University Hospital, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Infectious Diseases, University Hospital, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author><author><name sortKey="P Denphant, Jan" sort="P Denphant, Jan" uniqKey="P Denphant J" first="Jan" last="P Denphant">Jan P Denphant</name></author><author><name sortKey="Ravn, Pernille" sort="Ravn, Pernille" uniqKey="Ravn P" first="Pernille" last="Ravn">Pernille Ravn</name></author></analytic><series><title level="j">BMJ case reports</title><idno type="eISSN">1757-790X</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antibodies, Monoclonal, Humanized (adverse effects)</term><term>Antirheumatic Agents (adverse effects)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term><term>Staphylococcal Infections (chemically induced)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Anticorps monoclonaux humanisés (effets indésirables)</term><term>Antirhumatismaux (effets indésirables)</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Infections à staphylocoques ()</term><term>Mâle</term><term>Sujet âgé</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term><term>Antirheumatic Agents</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Staphylococcal Infections</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Anticorps monoclonaux humanisés</term><term>Antirhumatismaux</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Infections à staphylocoques</term><term>Mâle</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We report three cases of severe disseminated Staphylococcus aureus infection in patients with rheumatoid arthritis (RA) treated with tocilizumab. Tocilizumab is a new drug, unknown to most internists, and injections given weeks before admission may not be considered by the patient as part of their 'current medical treatment', and the physician may not be aware that the patient is severely immunosuppressed. Severe infections in RA patients treated with tocilizumab may present with mild symptoms despite severe and disseminated infection and, as these patients are severely immunodeficient-intensive diagnostic work-up and early treatment should be performed. Systematic postmarketing studies are needed to clarify if there is a true increased risk of disseminated S aureus infections. We suggest caution when prescribing tocilizumab to patients with prosthetic joints and/or prior invasive S aureus infections and that patients are taught to inform health staff about their medication history and their increased risk of infection.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23283607</PMID><DateCompleted><Year>2013</Year><Month>06</Month><Day>03</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1757-790X</ISSN><JournalIssue CitedMedium="Internet"><Volume>2013</Volume><PubDate><Year>2013</Year><Month>Jan</Month><Day>02</Day></PubDate></JournalIssue><Title>BMJ case reports</Title><ISOAbbreviation>BMJ Case Rep</ISOAbbreviation></Journal><ArticleTitle>Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1136/bcr-2012-007413</ELocationID><ELocationID EIdType="pii" ValidYN="Y">bcr2012007413</ELocationID><Abstract><AbstractText>We report three cases of severe disseminated Staphylococcus aureus infection in patients with rheumatoid arthritis (RA) treated with tocilizumab. Tocilizumab is a new drug, unknown to most internists, and injections given weeks before admission may not be considered by the patient as part of their 'current medical treatment', and the physician may not be aware that the patient is severely immunosuppressed. Severe infections in RA patients treated with tocilizumab may present with mild symptoms despite severe and disseminated infection and, as these patients are severely immunodeficient-intensive diagnostic work-up and early treatment should be performed. Systematic postmarketing studies are needed to clarify if there is a true increased risk of disseminated S aureus infections. We suggest caution when prescribing tocilizumab to patients with prosthetic joints and/or prior invasive S aureus infections and that patients are taught to inform health staff about their medication history and their increased risk of infection.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Mai T T</ForeName><Initials>MT</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, University Hospital, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pødenphant</LastName><ForeName>Jan</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Ravn</LastName><ForeName>Pernille</ForeName><Initials>P</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>01</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ Case Rep</MedlineTA><NlmUniqueID>101526291</NlmUniqueID><ISSNLinking>1757-790X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D061067">Antibodies, Monoclonal, Humanized</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018501">Antirheumatic Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>I031V2H011</RegistryNumber><NameOfSubstance UI="C502936">tocilizumab</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D061067" MajorTopicYN="N">Antibodies, Monoclonal, Humanized</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018501" MajorTopicYN="N">Antirheumatic Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013203" MajorTopicYN="N">Staphylococcal Infections</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="Y">chemically induced</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>1</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>1</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>6</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23283607</ArticleId><ArticleId IdType="pii">bcr-2012-007413</ArticleId><ArticleId IdType="doi">10.1136/bcr-2012-007413</ArticleId><ArticleId IdType="pmc">PMC3603831</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Nat Clin Pract Rheumatol. 2006 Nov;2(11):619-26</Citation><ArticleIdList><ArticleId IdType="pubmed">17075601</ArticleId></ArticleIdList></Reference><Reference><Citation>Lancet Infect Dis. 2011 Mar;11(3):208-22</Citation><ArticleIdList><ArticleId IdType="pubmed">21371655</ArticleId></ArticleIdList></Reference><Reference><Citation>Mod Rheumatol. 2012 Feb;22(1):122-7</Citation><ArticleIdList><ArticleId IdType="pubmed">21735355</ArticleId></ArticleIdList></Reference><Reference><Citation>Rheumatology (Oxford). 2012 Mar;51(3):577-8</Citation><ArticleIdList><ArticleId IdType="pubmed">22096010</ArticleId></ArticleIdList></Reference><Reference><Citation>Arthritis Res Ther. 2011;13(5):R141</Citation><ArticleIdList><ArticleId IdType="pubmed">21884601</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Danemark</li></country></list><tree><noCountry><name sortKey="P Denphant, Jan" sort="P Denphant, Jan" uniqKey="P Denphant J" first="Jan" last="P Denphant">Jan P Denphant</name><name sortKey="Ravn, Pernille" sort="Ravn, Pernille" uniqKey="Ravn P" first="Pernille" last="Ravn">Pernille Ravn</name></noCountry><country name="Danemark"><noRegion><name sortKey="Nguyen, Mai T T" sort="Nguyen, Mai T T" uniqKey="Nguyen M" first="Mai T T" last="Nguyen">Mai T T. 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