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Empyema in a patient treated with infliximab: it is not what it seems
  1. A Bossink1,
  2. S Thijsen2,
  3. A J van Houte3
  1. 1Heart Lung Centre, and Diakonessenhuis, Utrecht, The Netherlands
  2. 2Diakonessenhuis, Utrecht, The Netherlands
  3. 3Diakonessenhuis, Utrecht and Antonius Ziekenhuis, Nieuwegein, The Netherlands
  1. Correspondence to:
    Dr A Bossink
    Bosboomstraat 1, Utrecht, The Netherlands; aikbossinkmac.com

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A 68 year old woman, treated with prednisone and infliximab for rheumatoid arthritis, presented with two periods of thoracic empyema in two subsequent winters. H influenzae was cultured in the first infectious period and S pneumoniae during the second. Direct stains, polymerase chain reaction, and cultures for mycobacteria remained negative in both periods. She was treated with intravenous antibiotics and a closed drainage system. Infliximab was discontinued after the first infectious …

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