The clinical studies and case presentations discussed here serve to remind clinicians that timely acquisition and evaluation of blood cultures are essential to the identification of serious bacteriologic pathogens, and to the chances of recovery in the RA patient with a systemic infection who is immunosuppressed as a result of treatment with infliximab or other anti-TNF agent. Rapid identification of pathogenic organisms will facilitate the implementation of appropriate therapy, thus avoiding the often-deadly outcomes of severe infection and sepsis. Gram-stain, anaerobic, and aerobic blood cultures with sensitivities should be considered the standard of care in any infliximab-treated patient who presents with fever, a patient report of a fever, or any other signs, symptoms, or patient history that could suggest infection.
While this article focuses for the most part on infections associated with infliximab use, the same strategy in standard of practice should apply to all patients who use anti-TNF therapy for treatment of RA.
