Purulent pericarditis in a patient with rheumatoid arthritis treated with etanercept and methotrexate

CJEM. 2007 Jan;9(1):40-2.

Abstract

Purulent pericarditis is rarely seen in this post-antibiotic era. We report a case of spontaneous purulent pericarditis in a patient with rheumatoid arthritis being treated with etanercept, a tumour necrosis factor-alpha (TNF-alpha) antagonist, and methotrexate, an immunosuppressant. Both are disease-modifying anti-rheumatic drugs. We discuss the pathophysiology of purulent pericarditis and the recent literature on the infectious complications of TNF-alpha antagonists.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antirheumatic Agents / administration & dosage
  • Antirheumatic Agents / adverse effects*
  • Arthritis, Rheumatoid / drug therapy
  • Etanercept
  • Female
  • Humans
  • Immunoglobulin G / administration & dosage
  • Immunoglobulin G / adverse effects*
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects*
  • Pericarditis / microbiology*
  • Receptors, Tumor Necrosis Factor / administration & dosage
  • Staphylococcal Infections / diagnosis
  • Staphylococcus aureus / isolation & purification
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Antirheumatic Agents
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • Etanercept
  • Methotrexate