The important role that TNF has in granuloma formation and maintenance, which is essential in host defense against mycobacteria, has been demonstrated by the many cases of tuberculosis reactivation described.[7,8,9] Few cases of nontuberculous mycobacterial infections in patients receiving anti-TNF therapy have been reported.[9,10,11] Given the low incidence and lack of good diagnostic instruments, specific screening for nontuberculous mycobacterial infections is currently not feasible; however, candidates for anti-TNF treatment with known lung disease, specifically COPD and bronchiectasis, should have their sputum repeatedly cultured for mycobacteria. Furthermore, clinicians involved in anti-TNF treatment should be aware of the potential emergence of nontuberculous mycobacterial infections in their patients. If a nontuberculous mycobacterial infection occurs, strictly supervised continuation of anti-TNF agents during antimycobacterial treatment might be safe and effective.
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Jakko van Ingen, Radboud University Nijmegen Medical Center, Department of Pulmonary Diseases (454), PO Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: firstname.lastname@example.org .
Nat Clin Pract Rheumatol. 2007;3(7):414-419. © 2007 Nature Publishing Group
Cite this: Pulmonary Mycobacterium szulgai Infection and Treatment in a Patient Receiving Anti-Tumor Necrosis Factor Therapy - Medscape - Jul 01, 2007.