A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report

Recently, treatment for rheumatoid arthritis has dramatically improved but increases the risk of bacterial and opportunistic infections. Herein, we report a fatal case of concurrent disseminated tuberculosis, pneumocystis pneumonia, and septic shock due to pyelonephritis caused by extended-spectrum...

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Autores principales: Ohmura, Shin-Ichiro, Ishihara, Ryuhei, Mitsui, Ayaka, Otsuki, Yoshiro, Miyamoto, Toshiaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440108/
https://www.ncbi.nlm.nih.gov/pubmed/34532148
http://dx.doi.org/10.1155/2021/7842049
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author Ohmura, Shin-Ichiro
Ishihara, Ryuhei
Mitsui, Ayaka
Otsuki, Yoshiro
Miyamoto, Toshiaki
author_facet Ohmura, Shin-Ichiro
Ishihara, Ryuhei
Mitsui, Ayaka
Otsuki, Yoshiro
Miyamoto, Toshiaki
author_sort Ohmura, Shin-Ichiro
collection PubMed
description Recently, treatment for rheumatoid arthritis has dramatically improved but increases the risk of bacterial and opportunistic infections. Herein, we report a fatal case of concurrent disseminated tuberculosis, pneumocystis pneumonia, and septic shock due to pyelonephritis caused by extended-spectrum β-lactamase-producing Escherichia coli in a patient with rheumatoid arthritis who received methotrexate, glucocorticoid, and tocilizumab. Despite undergoing intensive treatment, the patient developed respiratory failure and died after 7 days of admission. An autopsy indicated that pulmonary tuberculosis were the ultimate causes of death, while pyelonephritis was controlled.
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spelling pubmed-84401082021-09-15 A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report Ohmura, Shin-Ichiro Ishihara, Ryuhei Mitsui, Ayaka Otsuki, Yoshiro Miyamoto, Toshiaki Case Rep Rheumatol Case Report Recently, treatment for rheumatoid arthritis has dramatically improved but increases the risk of bacterial and opportunistic infections. Herein, we report a fatal case of concurrent disseminated tuberculosis, pneumocystis pneumonia, and septic shock due to pyelonephritis caused by extended-spectrum β-lactamase-producing Escherichia coli in a patient with rheumatoid arthritis who received methotrexate, glucocorticoid, and tocilizumab. Despite undergoing intensive treatment, the patient developed respiratory failure and died after 7 days of admission. An autopsy indicated that pulmonary tuberculosis were the ultimate causes of death, while pyelonephritis was controlled. Hindawi 2021-09-07 /pmc/articles/PMC8440108/ /pubmed/34532148 http://dx.doi.org/10.1155/2021/7842049 Text en Copyright © 2021 Shin-Ichiro Ohmura et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Ohmura, Shin-Ichiro
Ishihara, Ryuhei
Mitsui, Ayaka
Otsuki, Yoshiro
Miyamoto, Toshiaki
A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report
title A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report
title_full A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report
title_fullStr A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report
title_full_unstemmed A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report
title_short A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report
title_sort fatal case of concurrent disseminated tuberculosis, pneumocystis pneumonia, and bacterial septic shock in a patient with rheumatoid arthritis receiving methotrexate, glucocorticoid, and tocilizumab: an autopsy report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440108/
https://www.ncbi.nlm.nih.gov/pubmed/34532148
http://dx.doi.org/10.1155/2021/7842049
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