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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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2021/7842049 |
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| author | Shin-Ichiro Ohmura Ryuhei Ishihara Ayaka Mitsui Yoshiro Otsuki Toshiaki Miyamoto |
| author_facet | Shin-Ichiro Ohmura Ryuhei Ishihara Ayaka Mitsui Yoshiro Otsuki Toshiaki Miyamoto |
| author_sort | Shin-Ichiro Ohmura |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-30002478f3944bfd820abd3bff010ed1 |
| institution | Kabale University |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-30002478f3944bfd820abd3bff010ed12025-02-03T05:45:20ZengWileyCase Reports in Rheumatology2090-68892090-68972021-01-01202110.1155/2021/78420497842049A 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 ReportShin-Ichiro Ohmura0Ryuhei Ishihara1Ayaka Mitsui2Yoshiro Otsuki3Toshiaki Miyamoto4Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka, Hamamatsu, JapanDepartment of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka, Hamamatsu, JapanDepartment of Pathology, Seirei Hamamatsu General Hospital, Shizuoka, Hamamatsu, JapanDepartment of Pathology, Seirei Hamamatsu General Hospital, Shizuoka, Hamamatsu, JapanDepartment of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka, Hamamatsu, JapanRecently, 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.http://dx.doi.org/10.1155/2021/7842049 |
| spellingShingle | Shin-Ichiro Ohmura Ryuhei Ishihara Ayaka Mitsui Yoshiro Otsuki Toshiaki Miyamoto 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 Case Reports in Rheumatology |
| 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 |
| url | http://dx.doi.org/10.1155/2021/7842049 |
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