Respiratory infections associated with anti-TNF α agents.

Respiratory infections associated with anti-TNFα agents. Med Mal Infect. 2017 Jun 08;: Authors: Blanchard E, Truchetet ME, Machelart I, Séneschal J, Raherison-Semjen C Abstract Anti-TNFα agents have proved effective in the treatment of various inflammatory, rheumatologic, dermatologic, and gastrointestinal diseases. Severe respiratory tract infections of bacterial or fungal origin have emerged as important complications in patients receiving such treatments. The risk of infection due to anti-TNFα therapy is difficult to assess in these patients who are immunocompromised because of the underlying disease itself and of previous or concomitant immunosuppressive drugs. This excessive infection risk seems real, particularly in the first six months following treatment initiation, and higher for patients receiving anti-TNFα monoclonal antibodies than for those receiving soluble TNFα receptor. The involved pathogens are pyogenic bacteria but also Mycobacterium tuberculosis, mostly by reactivation of latent tuberculosis infection, warranting a systematic preventive approach to screening and chemoprophylaxis before initiating the anti-TNFα therapy. In countries with low tuberculosis endemicity, an increased prevalence of nontuberculous mycobacterial infections has been reported. The incidence rate of legionellosis is high in this population. In case of pneumonia, empirical antibiotic therapy should cover Legionella pneumophila. Severa...
Source: Medecine et Maladies Infectieuses - Category: Infectious Diseases Tags: Med Mal Infect Source Type: research