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Case Reports
Psoas and Mediastinal Abscesses During Intravenous Tocilizumab Treatment in Multicentric Castleman Disease.
- Kazuto Togitani, Fumiya Ogasawara, Yu Arakawa, Natsuki Sugimura, Ryohei Miyazaki, and Kensuke Kojima.
- Department of Hematology, Kochi Medical School, Kochi University, Japan.
- Intern. Med. 2023 Feb 1; 62 (3): 449452449-452.
AbstractTocilizumab 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.
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