Risk of Nocardial Infections With Anti-tumor Necrosis Factor Therapy

Anti-tumor necrosis factor (anti-TNF) therapy is beneficial in the management of many chronic immune-mediated inflammatory diseases. However, its use is associated with increased risk of bacterial, fungal and viral infections. We present a case of cutaneous nocardiosis that occurred in a 61-year-old man, whose Crohn's disease was treated for nearly 1.5 years with infliximab. Prompt therapy with trimethoprim-sulfamethoxazole led to complete resolution. Only few cases of nocardiosis complicating anti-TNF therapy are reported in the literature. We present the case report and summary of the available literature with updates on the management and the treatment of the disease.