An atypical mycobacterial infection arising in a patient on adalimumab treatment

Abstract

It has been well documented that patients on immunosuppressive therapies, especially anti-tumour necrosis factor therapy, are at risk for mycobacterial infections. Aside from the typical mycobacterium tuberculosis infection, atypical mycobacterial infections occur more rarely and tend to take a more challenging and prolonged course as a result of delayed diagnosis. We report a case of mycobacterium marinum, acquired from a public pool, in a man with Crohn's disease managed on adalimumab. This was treated successfully with doxycycline and cessation of adalimumab. This case underlines that patient pastimes or occupations may carry an increased risk of infection with mycobacterium marinum. Prior to commencing immunosuppressive therapy, it may be beneficial that patients are counselled about this increased risk, considering mycobacterial infections require long-term antibiotic treatment and in some cases, cessation of otherwise very effective medication.L723041302016-06-29 <br />