The Challenge of Tuberculosis Infection Related to Adalimumab: A Subtle and Rare Presentation

Juliana Lopes, Ana Machado, Sara Martins, Sara Pires, Catarina Branco, Joana Fragoso, Diogo Guerra, Patricia Campos, Mariana Brandao, Graziela Carvalheiras, Teresa Mendonca


With the increasing use of biological therapies, there was a concomitant increase in concern and sensitivity for associated opportunistic infections. There has been growing evidence that anti-tumor necrosis factor (TNF) therapy increases the risk of opportunistic infection. Screening for latent tuberculosis (TB) prior to initiation of therapy has reduced the incidence of active TB, although it is not completely preventable. The possibility of active TB should always be considered in immunosuppressed patients under anti-TNF therapy. We report a case of muscular TB with psoas abscess in a patient under adalimumab. This case highlights the importance of the high suspicion threshold for Mycobacterium tuberculosis infection, in patients with subtle symptoms.

J Med Cases. 2018;9(1):23-25


Tuberculosis; Psoas muscle abscess; Anti-TNF; Adalimumab; Intestinal Behcet

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.