Large paraspinal abscess as a complication of infliximab therapy in Crohn’s disease
We report a 36-year-old man who developed a large epidural and paraspinal abscess as a complication of infliximab therapy being used for underlying Crohn’s disease. Cultures of the collection grew methicillin-susceptible Staphylococcus aureus, and treatment consisted of abscess drainage, prolonged i...
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| Veröffentlicht in: | BMJ case reports 2019-04, Vol.12 (4), p.e227665 |
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| creator | Nithianandan, Nishani Loftus, Michael J Johnson, Paul D R Charles, Patrick G P |
| description | We report a 36-year-old man who developed a large epidural and paraspinal abscess as a complication of infliximab therapy being used for underlying Crohn’s disease. Cultures of the collection grew methicillin-susceptible Staphylococcus aureus, and treatment consisted of abscess drainage, prolonged intravenous and oral flucloxacillin and temporary withholding of his infliximab. While infection-related complications are well described with infliximab therapy, this is the first description of a large paraspinal abscess with epidural extension. |
| doi_str_mv | 10.1136/bcr-2018-227665 |
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Cultures of the collection grew methicillin-susceptible Staphylococcus aureus, and treatment consisted of abscess drainage, prolonged intravenous and oral flucloxacillin and temporary withholding of his infliximab. While infection-related complications are well described with infliximab therapy, this is the first description of a large paraspinal abscess with epidural extension.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2018-227665</identifier><identifier>PMID: 31036734</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abscess - diagnostic imaging ; Abscess - drug therapy ; Abscess - microbiology ; Abscess - surgery ; Abscesses ; Adult ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Antibodies, Monoclonal ; Back pain ; Biological products ; Case reports ; Crohn Disease - complications ; Crohn Disease - drug therapy ; Crohn's disease ; Drainage - methods ; Drug dosages ; Drug use ; Epidural Space - diagnostic imaging ; Epidural Space - microbiology ; Floxacillin - administration & dosage ; Floxacillin - therapeutic use ; Gastrointestinal Agents - adverse effects ; Gastrointestinal Agents - therapeutic use ; Humans ; Immunotherapy ; Infections ; Inflammatory bowel disease ; Infliximab - adverse effects ; Infliximab - therapeutic use ; Male ; Meta-analysis ; Monoclonal antibodies ; NMR ; Nuclear magnetic resonance ; Patients ; Penicillin ; Rare Disease ; Rheumatoid arthritis ; Staphylococcal Infections - diagnosis ; Staphylococcal Infections - drug therapy ; Staphylococcus aureus - isolation & purification ; Substance abuse treatment ; Systematic review ; TNF inhibitors ; Treatment Outcome ; Tumor necrosis factor-TNF</subject><ispartof>BMJ case reports, 2019-04, Vol.12 (4), p.e227665</ispartof><rights>BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2019 BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b456t-82e2fd0b0400005fadd37e80164c1d6949c932207b48d199c849a6bf65df08d03</citedby><cites>FETCH-LOGICAL-b456t-82e2fd0b0400005fadd37e80164c1d6949c932207b48d199c849a6bf65df08d03</cites><orcidid>0000-0003-1165-4926</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506107/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506107/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31036734$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nithianandan, Nishani</creatorcontrib><creatorcontrib>Loftus, Michael J</creatorcontrib><creatorcontrib>Johnson, Paul D R</creatorcontrib><creatorcontrib>Charles, Patrick G P</creatorcontrib><title>Large paraspinal abscess as a complication of infliximab therapy in Crohn’s disease</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>We report a 36-year-old man who developed a large epidural and paraspinal abscess as a complication of infliximab therapy being used for underlying Crohn’s disease. Cultures of the collection grew methicillin-susceptible Staphylococcus aureus, and treatment consisted of abscess drainage, prolonged intravenous and oral flucloxacillin and temporary withholding of his infliximab. While infection-related complications are well described with infliximab therapy, this is the first description of a large paraspinal abscess with epidural extension.</description><subject>Abscess - diagnostic imaging</subject><subject>Abscess - drug therapy</subject><subject>Abscess - microbiology</subject><subject>Abscess - surgery</subject><subject>Abscesses</subject><subject>Adult</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Antibodies, Monoclonal</subject><subject>Back pain</subject><subject>Biological products</subject><subject>Case reports</subject><subject>Crohn Disease - complications</subject><subject>Crohn Disease - drug therapy</subject><subject>Crohn's disease</subject><subject>Drainage - methods</subject><subject>Drug dosages</subject><subject>Drug use</subject><subject>Epidural Space - diagnostic imaging</subject><subject>Epidural Space - microbiology</subject><subject>Floxacillin - administration & dosage</subject><subject>Floxacillin - therapeutic use</subject><subject>Gastrointestinal Agents - adverse effects</subject><subject>Gastrointestinal Agents - therapeutic use</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Infections</subject><subject>Inflammatory bowel disease</subject><subject>Infliximab - adverse effects</subject><subject>Infliximab - therapeutic use</subject><subject>Male</subject><subject>Meta-analysis</subject><subject>Monoclonal antibodies</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patients</subject><subject>Penicillin</subject><subject>Rare Disease</subject><subject>Rheumatoid arthritis</subject><subject>Staphylococcal Infections - diagnosis</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcus aureus - isolation & purification</subject><subject>Substance abuse treatment</subject><subject>Systematic review</subject><subject>TNF inhibitors</subject><subject>Treatment Outcome</subject><subject>Tumor necrosis factor-TNF</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFUctKAzEUDaJoqV27k4A7YTSvycxsBCm-oODGgruQ17Qp08mYTEV3_oa_55eY0ip15SVwL8m5J4dzADjB6AJjyi-VDhlBuMwIKTjP98AAF3mRFRV63t-Zj8AoxgVKRTErGT0ERxQjygvKBmA6kWFmYSeDjJ1rZQOlitrGCGU6UPtl1zgte-db6Gvo2rpxb24pFeznNsjuPV3BcfDz9uvjM0LjopXRHoODWjbRjrZ9CKa3N0_j-2zyePcwvp5kiuW8z0piSW2QQmytLq-lMbSwJcKcaWx4xSpdUUJQoVhpcFXpklWSq5rnpkalQXQIrja83UotrdG27YNsRBeSwvAuvHTi70vr5mLmXwXPEceoSARnW4LgX1Y29mLhVyHZEAUhmCePULJ6CC43KB18jMHWvz9gJNZRiBSFWEchNlGkjdNdYb_4H-MT4HwDUMvFv2zf76mTFw</recordid><startdate>20190401</startdate><enddate>20190401</enddate><creator>Nithianandan, Nishani</creator><creator>Loftus, Michael J</creator><creator>Johnson, Paul D R</creator><creator>Charles, Patrick G P</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1165-4926</orcidid></search><sort><creationdate>20190401</creationdate><title>Large paraspinal abscess as a complication of infliximab therapy in Crohn’s disease</title><author>Nithianandan, Nishani ; Loftus, Michael J ; Johnson, Paul D R ; Charles, Patrick G P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b456t-82e2fd0b0400005fadd37e80164c1d6949c932207b48d199c849a6bf65df08d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abscess - diagnostic imaging</topic><topic>Abscess - drug therapy</topic><topic>Abscess - microbiology</topic><topic>Abscess - surgery</topic><topic>Abscesses</topic><topic>Adult</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Antibodies, Monoclonal</topic><topic>Back pain</topic><topic>Biological products</topic><topic>Case reports</topic><topic>Crohn Disease - complications</topic><topic>Crohn Disease - drug therapy</topic><topic>Crohn's disease</topic><topic>Drainage - methods</topic><topic>Drug dosages</topic><topic>Drug use</topic><topic>Epidural Space - diagnostic imaging</topic><topic>Epidural Space - microbiology</topic><topic>Floxacillin - administration & dosage</topic><topic>Floxacillin - therapeutic use</topic><topic>Gastrointestinal Agents - adverse effects</topic><topic>Gastrointestinal Agents - therapeutic use</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Infections</topic><topic>Inflammatory bowel disease</topic><topic>Infliximab - adverse effects</topic><topic>Infliximab - therapeutic use</topic><topic>Male</topic><topic>Meta-analysis</topic><topic>Monoclonal antibodies</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patients</topic><topic>Penicillin</topic><topic>Rare Disease</topic><topic>Rheumatoid arthritis</topic><topic>Staphylococcal Infections - diagnosis</topic><topic>Staphylococcal Infections - drug therapy</topic><topic>Staphylococcus aureus - isolation & purification</topic><topic>Substance abuse treatment</topic><topic>Systematic review</topic><topic>TNF inhibitors</topic><topic>Treatment Outcome</topic><topic>Tumor necrosis factor-TNF</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nithianandan, Nishani</creatorcontrib><creatorcontrib>Loftus, Michael J</creatorcontrib><creatorcontrib>Johnson, Paul D R</creatorcontrib><creatorcontrib>Charles, Patrick G P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nithianandan, Nishani</au><au>Loftus, Michael J</au><au>Johnson, Paul D R</au><au>Charles, Patrick G P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Large paraspinal abscess as a complication of infliximab therapy in Crohn’s disease</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2019-04-01</date><risdate>2019</risdate><volume>12</volume><issue>4</issue><spage>e227665</spage><pages>e227665-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>We report a 36-year-old man who developed a large epidural and paraspinal abscess as a complication of infliximab therapy being used for underlying Crohn’s disease. Cultures of the collection grew methicillin-susceptible Staphylococcus aureus, and treatment consisted of abscess drainage, prolonged intravenous and oral flucloxacillin and temporary withholding of his infliximab. While infection-related complications are well described with infliximab therapy, this is the first description of a large paraspinal abscess with epidural extension.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>31036734</pmid><doi>10.1136/bcr-2018-227665</doi><orcidid>https://orcid.org/0000-0003-1165-4926</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Abscess - diagnostic imaging Abscess - drug therapy Abscess - microbiology Abscess - surgery Abscesses Adult Anti-Bacterial Agents - therapeutic use Antibiotics Antibodies, Monoclonal Back pain Biological products Case reports Crohn Disease - complications Crohn Disease - drug therapy Crohn's disease Drainage - methods Drug dosages Drug use Epidural Space - diagnostic imaging Epidural Space - microbiology Floxacillin - administration & dosage Floxacillin - therapeutic use Gastrointestinal Agents - adverse effects Gastrointestinal Agents - therapeutic use Humans Immunotherapy Infections Inflammatory bowel disease Infliximab - adverse effects Infliximab - therapeutic use Male Meta-analysis Monoclonal antibodies NMR Nuclear magnetic resonance Patients Penicillin Rare Disease Rheumatoid arthritis Staphylococcal Infections - diagnosis Staphylococcal Infections - drug therapy Staphylococcus aureus - isolation & purification Substance abuse treatment Systematic review TNF inhibitors Treatment Outcome Tumor necrosis factor-TNF |
| title | Large paraspinal abscess as a complication of infliximab therapy in Crohn’s disease |
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