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-Reference-Cited by-同舟云学术

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

Published:2021-09-07 Issue: Volume:2021 Page:1-6
ISSN:2090-6897
Container-title:Case Reports in Rheumatology
language:en
Short-container-title:Case Reports in Rheumatology

Author:

Ohmura Shin-Ichiro¹^ORCID,Ishihara Ryuhei¹,Mitsui Ayaka²,Otsuki Yoshiro²,Miyamoto Toshiaki¹

Affiliation:

1. Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka, Hamamatsu, Japan

2. Department of Pathology, Seirei Hamamatsu General Hospital, Shizuoka, Hamamatsu, Japan

Abstract

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.

Publisher

Hindawi Limited

Subject

General Agricultural and Biological Sciences

Link

http://downloads.hindawi.com/journals/crirh/2021/7842049.pdf

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