Disseminated cutaneous Herpes Simplex Virus-1 in a woman with rheumatoid arthritis receiving infliximab: a case report.

Journal of Medical Case Reports
Elizabeth Ann JusticeParesh Jobanputra

Abstract

We present the case of a 49-year-old woman with a seronegative rheumatoid arthritis who developed pustular psoriasis whilst on etanercept and subsequently developed disseminated herpes simplex on infliximab. Our patient presented with an inflammatory arthritis which failed to respond to both methotrexate and leflunomide, and sulphasalazine treatment led to side effects. She was started on etanercept but after 8 months of treatment developed scaly pustular lesions on her palms and soles typical of pustular psoriasis. Following the discontinuation of etanercept, our patient required high doses of oral prednisolone to control her inflammatory arthritis. A second biologic agent, infliximab, was introduced in addition to low-dose methotrexate and 15 mg of oral prednisolone. However, after just 3 infusions of infliximab, she was admitted to hospital with a fever, widespread itchy vesicular rash and worsening inflammatory arthritis. Fluid from skin vesicles examined by polymerase chain reaction showed Herpes Simplex Virus type 1. Blood cultures were negative and her chest X-ray was normal. Her infliximab was discontinued and she was started on acyclovir, 800 mg five times daily for 2 weeks. She made a good recovery with improvement in...Continue Reading

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Citations

Mar 2, 2010·Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology·Eigo TakahashiAkio Yamada
Aug 21, 2014·Ocular Immunology and Inflammation·Paula Larrañaga FragosoMarta Mora Rillo
Mar 15, 2013·Parasitology International·Kelly Fernandes de Paula RodriguesMarcelo M Pinheiro
Nov 17, 2009·Journal of the American Academy of Dermatology·Jennifer AhdoutMelvin W Chiu
Mar 11, 2010·International Journal of STD & AIDS·D WatanabeY Matsumoto
Jul 3, 2013·Therapeutic Advances in Chronic Disease·Katarzyna OrlickaEmma L Culver
Sep 11, 2018·Expert Review of Anti-infective Therapy·Ivan NoreñaJosé María Aguado
Nov 9, 2019·Genome Biology·Anna RamischMartin Vingron
Jul 20, 2019·Clinical Medicine Insights. Case Reports·Kanika GoelJan F Silverman
May 24, 2020·Infectious Disease Clinics of North America·Dora Y HoAshrit Multani
Jul 20, 2016·Pediatrics·H Dele Davies, UNKNOWN COMMITTEE ON INFECTIOUS DISEASES

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Methods Mentioned

BETA
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