PT  - JOURNAL ARTICLE
AU  - C S Ngiu
AU  - M S Mohamed Said
AU  - P Periyasamy
AU  - S F Low
TI  - Nocardiosis in a patient with rheumatoid athritis treated with rituximab and a summary of reported cases
AID  - 10.1136/bcr.11.2009.2421
DP  - 2010 Jan 01
TA  - BMJ Case Reports
PG  - bcr1120092421
VI  - 2010
4099  - http://casereports.bmj.com/content/2010/bcr.11.2009.2421.short
4100  - http://casereports.bmj.com/content/2010/bcr.11.2009.2421.full
AB  - Rituximab is a B-cell-depleting monoclonal anti-CD20 antibody. It is widely used in haematology and rheumatology. However, usage of rituximab in immunosupressed patient has been associated with various opportunistic infections. The authors reported a case of refractory rheumatoid arthritis treated with rituximab, which later presented with non-resolving pneumonia with pulmonary nodule. Percutaneous computer tomogram guided lung biopsy was arranged to confirm the suspicion of tuberculosis, but did not yield conclusive results. Later, she presented left-chest abscess and underwent incision and drainage. The pus culture and sensitivity confirmed pulmonary nocardiosis with chest wall dissemination. She was treated with 2-week course of trimethoprim sulfamethoxazole and responded. The authors also reviewed published cases of nocardiosis post-rituximab.