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Infliximab is a human-murine chimeric monoclonal antibody directed against tumor necrosis factor alpha (TNFalpha). Infliximab and other TNF blockers are used to treat inflammatory diseases such as rheumatoid arthritis (RA). TNF blockers are suspected to play a key role in some infections. We report here two cases of Listeria monocytogenes sepsis associated with infliximab treatment for RA. The first patient developed a terminal ileitis and a bacteraemia after three doses of infliximab; the second RA patient presented a bacteraemia associated with a prosthetic joint arthritis of the left hip, both related to Listeria. Those two cases occurred in a population of 518 patients treated with TNF blockers in our hospitals since the year 2000. Those events are of particular interest because of the severity of the infection, because the treatment differs from other infections, and because that, in the rheumatology unit, septic arthritis can mimic RA symptoms. They enhance the likelihood for this drug to increase the risk for infections with germs like Listeria.

Original publication

DOI

10.1007/s10067-007-0660-8

Type

Journal

Clinical rheumatology

Publication Date

12/2007

Volume

26

Pages

2173 - 2175

Addresses

Microbiology Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain, MBLG 54.92, Avenue Hippocrate, 54, 1200, Brussels, Belgium. tk@agora.eu.org.

Keywords

Humans, Listeria monocytogenes, Arthritis, Rheumatoid, Tumor Necrosis Factor-alpha, Antirheumatic Agents, Antibodies, Monoclonal, Diagnosis, Differential, Aged, Middle Aged, Female, Male, Listeriosis, Infliximab