Orbital cellulitis in a patient receiving infliximab for Ankylosing spondylitis

Am J Ophthalmol. 2006 Apr;141(4):767-9. doi: 10.1016/j.ajo.2005.11.017.

Abstract

Purpose: To describe a case of orbital cellulitis arising in a patient treated with an anti-TNFalpha agent.

Design: Single interventional case report.

Methods: A 42-year-old man developed severe unilateral orbital cellulitis while receiving infliximab (Remicade, Centocor) treatment for Ankylosing spondylitis (AS) as part of the open-label phase of a trial conducted at our tertiary referral center. Cultures grew Staphylococcus aureus.

Results: Infliximab treatment was stopped and the patient made a full recovery after receiving appropriate antibiotic therapy. Infliximab therapy was resumed after three weeks.

Conclusions: Clinical vigilance is warranted when treating patients with anti-TNFalpha agents as these are associated with a diverse and growing number of ophthalmic complications. Resolved infection does not preclude the use of such agents.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amoxicillin-Potassium Clavulanate Combination / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Monoclonal / adverse effects*
  • Cefotaxime / therapeutic use
  • Cellulitis / diagnosis
  • Cellulitis / drug therapy
  • Cellulitis / etiology*
  • Drug Therapy, Combination
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / etiology*
  • Humans
  • Infliximab
  • Male
  • Microbial Sensitivity Tests
  • Orbital Diseases / diagnosis
  • Orbital Diseases / drug therapy
  • Orbital Diseases / etiology*
  • Randomized Controlled Trials as Topic
  • Spondylitis, Ankylosing / drug therapy*
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology*
  • Staphylococcus aureus / isolation & purification
  • Tumor Necrosis Factor-alpha / immunology

Substances

  • Anti-Bacterial Agents
  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha
  • Amoxicillin-Potassium Clavulanate Combination
  • Infliximab
  • Cefotaxime