CASE REPORT

Necrotising fasciitis in a patient receiving infliximab for rheumatoid arthritis

A T Y Chan, V Cleeve, T J Daymond

Rheumatology Department, Sunderland Royal Hospital, Sunderland, UK

Correspondence to:
Correspondence to:
Dr A T Y Chan, Rheumatology Department, Battle Hospital, Oxford Road, Reading RG30 1AG, UK;
antonichan{at}hotmail.com

A case of necrotising fasciitis in a patient receiving infliximab, an antitumour necrosis factor alpha (TNF-) agent for rheumatoid arthritis, is presented. A widespread confluent, erythematous, pustular skin rash was the presenting sign. There was no fever throughout this admission. ß-Haemolytic group A streptococcus was isolated from blood cultures and skin swabs. The adductor muscles and fascia around the site of a previous hip arthroplasty were necrotic on exploration. The case highlights the risk of severe sepsis in patients on anti-TNF- treatment.

Keywords: necrotising fasciitis; infliximab; rheumatoid arthritis; antitumour necrosis factor-alpha

Abbreviations: APTT, activated partial thromboplastin time; TNF-, tumour necrosis factor-alpha

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