종양괴사인자 억제제 사용 중인 류마티스 관절염 환자에서 B군 살모넬라균에 의한 화농성 관절염

Septic Arthritis caused by Group B Salmonella Species in a Patient with Rheumatoid Arthritis on Anti-TNF Alpha Therapy

Salmonellae are gram-negative bacilli of the family Enterobacteriaceae. Gastroenteritis was the most frequent clinical sign and osteoarticular infection like septic arthritis were extremely scarce in a patient with Salmonella infection. An immunocompromised state are known risk factors for development of septic arthritis due to Salmonella. The treatment of rheumatoid arthritis (RA) has recently seen a paradigm shift with the introduction of biological therapy. Tumor necrosis factor-alpha antagonist (anti TNF-α) have especially been able to play major roles in the treatment of RA. But there is concern that this will result in an increased incidence of infection. There have been few reports of Salmonella infection following anti TNF-αin a RA patient. Here, we report a rare case of septic arthritis of the left knee by Group B non-typhoidal Salmonella in a RA patient who was receiving etanercept therapy. The patients was treated with arthroscopy guided irrigation and debridement, and administration of intravenous antibiotics (ciprofloxacin) for 4 weeks. Since then, he achieved a full recovery from the infection.