Psoas and Mediastinal Abscesses during Intravenous Tocilizumab Treatment in Multicentric Castleman Disease

Tocilizumab has been used to treat idiopathic multicentric Castleman disease (iMCD). As tocilizumab prevents interleukin-6 from exerting pro-inflammatory effects, there is some concern about a delayed diagnosis of severe infections during tocilizumab treatment. Although serious infections during toc...

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Bibliographic Details
Published in:Internal Medicine 2023/02/01, Vol.62(3), pp.449-452
Main Authors: Togitani, Kazuto, Ogasawara, Fumiya, Arakawa, Yu, Sugimura, Natsuki, Miyazaki, Ryohei, Kojima, Kensuke
Format: Article
Language:English
Subjects:
Abscess
Abscesses
Case Report
Case reports
Castleman Disease - complications
Castleman Disease - diagnosis
Castleman Disease - drug therapy
Castleman's disease
Diabetes mellitus
Humans
Inflammation
Interleukin 6
Internal medicine
mediastinum
methicillin-susceptible Staphylococcus aureus
multicentric Castleman disease
psoas
Rheumatoid arthritis
Spondylodiscitis
Staphylococcus aureus
tocilizumab
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Summary:Tocilizumab has been used to treat idiopathic multicentric Castleman disease (iMCD). As tocilizumab prevents interleukin-6 from exerting pro-inflammatory effects, there is some concern about a delayed diagnosis of severe infections during tocilizumab treatment. Although serious infections during tocilizumab therapy have been previously described in patients with rheumatoid arthritis, they have not been reported in iMCD. We herein report a case of disseminated Staphylococcus aureus infection after a superficial skin wound followed by psoas and mediastinal abscesses with pyogenic spondylodiscitis in an iMCD patient with diabetes. Physicians should be alert for the occurrence of disseminated S. aureus infection after even minor skin injury during tocilizumab therapy.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9519-22