Affiliations 

  • 1 Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia. csngiu@ppukm.ukm.my
  • 2 Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia
BMJ Case Rep, 2010;2010.
PMID: 22778377 DOI: 10.1136/bcr.11.2009.2421

Abstract

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.