Nocardia asteroides pneumonia complicating low dose methotrexate treatment of refractory rheumatoid arthritis.

Cornelissen, J J; Bakker, L J; Van der Veen, M J; Rozenberg-Arska, M; Bijlsma, J W · Ann Rheum Dis · 1991

case_report · Level V

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Abstract

Low dose methotrexate is used increasingly often in the treatment of rheumatoid arthritis. Severe complications due to toxicity of the lung or bone marrow occur infrequently. This report describes a 71 year old woman with longstanding rheumatoid arthritis who developed pleuritis, a pulmonary infiltrate, and pancytopenia during treatment with low dose methotrexate. Fatal respiratory insufficiency followed, and cultures from the lung after death showed Nocardia asteroides.

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