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Purulent pericarditis in a patient with rheumatoid arthritis treated with etanercept and methotrexate
David D Sweet1, George Isac, Bruce Morrison
1Emergency Medicine and Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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.
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