Resumen de Infecciones oportunistas múltiples relacionadas con Infliximab en enfermedad inflamatoria intestinal: : ¿suspender o continuar la terapia biológica?
E. Merino Gallego, Carmen Molina Villalba, Eva Martínez Amate
- español
Los agentes anti-TNFα son ampliamente utilizados en la enfermedad inflamatoria intestinal. Sin embargo, se asocian a alto riesgo de infecciones oportunistas, las cuales pueden llegar a ser muy graves.
Presentamos dos casos de infecciones oportunistas asociadas al tratamiento con Infliximab: un caso de sepsis respiratoria por Legionella pneumophila que precisó ingreso en UCI junto con aspergilosis pulmonar y diarrea por Clostridium difficile en un paciente con enfermedad de Crohn y un caso de bacteriemia por Listeria monocytogenes en un paciente con colitis ulcerosa.
- English
Anti-TNF agents are widely used in inflammatory bowel disease. However, they are associated to an increased risk for developping opportunistic infections which can become very serious.
We report two cases of opportunistic infections associated to therapy with Infliximab: one case of respiratory sepsis due to Legionella pneumophila in addition to pulmonary aspergillosis and Clostridium difficile diarrhea in a patient with Crohn disease who required admission to the intensive care unit and a case of Listeria monocytogenes in a patient with ulcerative colitis.
Conclusions: biologic therapy should be discontinued during the infection. However, after the active infection, there is no consensus about restarting anti-TNF or stopping it temporarily or indefinitely. That decision should thus be individualized, taken into account factors such as patient characteristics or severity of the infection.
