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Infectious Disease

General Rheumatology   

Questions discussed in this category

Is there any role for administering another course of recombinant zoster vaccine (Shingrx) in a previously vaccinated patient with RA, who is in clinical remission on Jak inhibitor but has had a breakthrough shingles infection?
Last SHINGRIX was about 4 years ago and both doses were given.
2 Answers available
How would you treat an asymptomatic patient with a positive Blastomyces antibody, evidence of prior granulomatous lung disease on imaging, and who may require immunosuppression in the future?
1 Answer available
Do you routinely consider FDG PET/CT imaging for workup of fever of unknown origin?
1 Answer available
What are the current treatment options for progressive multifocal leukoencephalopathy in patients without HIV/AIDS?
Are there any clinical trials underway to study additional therapies?
1 Answer available
Would you use the pneumococcal conjugate-21 vaccine (Capvaxive) instead of the conjugate-20 (Prevnar-20) for routine vaccinations in immunosuppressed patients?
2 Answers available
How often do you see bony erosions in patients with Lyme arthritis?
1 Answer available
How do you approach a patient on anti-TNF with positive Quantiferon (previously negative) with negative chest x-ray and no symptoms?
7 Answers available
Are there any concerns with live vaccine innoculation and patients who are on denosumab?
1 Answer available
Is there a role for nitazoxanide for treatment of norovirus gastroenteritis in immunocompromised patients?
1 Answer available
Do you find HZV titers useful in diagnosing shingles sine herpete?
1 Answer available
Is there a risk of hepatitis C activation with rituximab in a patient who has a history of HCV treated with antivirals and who is in sustained viral response?
1 Answer available
What is your approach to counseling patients regarding re-initiation of anti-TNF therapy after completion of treatment for non-disseminated pulmonary histoplasmosis?
Would it be safe to resume and if so, when?
2 Answers available
For how long do you recommend treatment for latent tuberculosis prior to initiation of anti-TNF therapy?
6 Answers available
Does your institution have formal policies or work flows to reduce unnecessary IGRAs ordered for patients on biologics?
1 Answer available
What isolation policies are Rheumatology offices employing for both staff and patients diagnosed with COVID-19 given the new CDC guidelines?
CDC Healthcare Guidance CDC Isolation and Work Restriction Guidance CDC Immunocompromised Guidance
1 Answer available
How do you approach biologic initiation in patients with inflammatory arthritis and repeatedly indeterminate Quantiferon?
5 Answers available
How do you approach ongoing screening for TB in patients with a history of treated latent TB, but who have ongoing use of DMARDs and/or biologics given Quantiferon testing and PPD can remain positive?
How do you approach ongoing screening for TB in patients with history of treated latent TB, but have ongoing use of DMARDs and/or biologics given quan...
1 Answer available
What is your approach to working up diarrhea in an immunocompromised patient?
1 Answer available
Do you typically adjust or hold immunosuppression in a well-controlled RA patient who is being treated for Mycobacterium avium-intracellulare (MAI)?
1 Answer available
What else do you consider in the differential diagnosis for pulmonary-renal syndromes if there is low clinical and serologic evidence of AAV, Goodpasture's or other rheumatologic disease (SLE, RA, APS, Scleroderma)?
2 Answers available
Do you utilize post-vaccination IgG titers to detect common variable immunodeficiency in patients who are about to start or are actively on B cell depleting therapy?
2 Answers available
How do you manage a patient with severe RA or SLE that worsens after stopping immunosuppressants due to having chronic foot ulceration?
2 Answers available
Do you consider anti-viral prophylaxis in patients taking JAK inhibitors who have recurrent uncomplicated Zoster infection, but would prefer not changing therapy?
2 Answers available
How do you approach immunosuppression in patients with a positive Interferon Gamma Release Assay and prior intravesicular BCG treatment for bladder cancer?
Assuming no symptoms of TB, should patients be treated for latent TB prior to starting TNF inhibitors or other immunosuppressive agents?
1 Answer available
Do you have a preference between Quantiferon Gold and T-spot TB for screening in patients starting immunosuppressive agents?
1 Answer available
In patients taking biologics who are planning joint replacement and are known MRSA carriers do you perform decolonization prior to surgery?
0 Answers available
What is the optimal timing for Zoster vaccine administration for a patient who recently recovered from herpes zoster infection and is now planning to start B-cell depletion therapy?
1 Answer available
How do you approach management of patients with active RA and recurrent non-severe C.diff?
(Patient with active RA despite hydroxychloroquine)
1 Answer available
How do you approach the workup for a patient with persistently elevated inflammatory markers (CRP and ESR) whose history and exam do not point to a clear cause?
4 Answers available
How do you approach treatment of RA with methotrexate in a patient with treated Hepatitis C and normal liver function?
1 Answer available
Do you recommend continuous antibiotic prophylaxis for patients on complement inhibitors such as eculizumab?
Do you just use antibiotic prophylaxis if therapy is started prior to meningococcal vaccination?
3 Answers available
Which medications have the lowest risk of tuberculosis reactivation in patients with uncertain tuberculosis history and active rheumatologic disease?
2 Answers available
Do you recommend routine use of Evusheld for pre-exposure prophylaxis for patients on immunosuppression?
Does treatment with B-cell depletion and/or negative anti-spike antibody status despite COVID mRNA vaccination influence your decision?
1 Answer available
Is there a role for regular hepatitis and TB screening in patients on chronic immunosuppressive therapy in the absence of new risk factors or exposures?
1 Answer available
How do you think about biologic use in patients with underlying HIV infection?
2 Answers available
Do you hold tocilizumab for patients who are diagnosed with Covid and are with mild to moderate symptoms or non-hospitalized?
1 Answer available
Is there a role for antibody testing to confirm vaccine response for patients on rituximab after COVID-19 vaccination?
1 Answer available
When would you consider checking JC virus prior to initiating biologic therapy?
1 Answer available
How are you timing the third dose of the COVID-19 mRNA vaccine in patients on rituximab?
1 Answer available
How do you approach the evaluation of patients referred for chronic lyme disease and counsel patients regarding this entity?
1 Answer available
How does a history of splenectomy alter how you counsel patients on the infection risk of TNF inhibitors or other biologics?
1 Answer available
Are you recommending the mRNA COVID-19 vaccines to your patients with immune mediated inflammatory diseases?
5 Answers available
Would you hold all immunosuppressive medications for the first month of LTBI treatment, or just biologics?
1 Answer available
Do you avoid any specific biologic therapies in HIV positive patients?
1 Answer available
How do you manage patients who are Hepatitis B core antibody positive/surface antigen negative and starting a biologic DMARD (other than rituximab)?
1 Answer available


Papers discussed in this category

Arthritis Rheumatol, 2016 Jan
2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.
Arthritis care & research, 2017-03
Rates of Serious Infections in HIV-Infected Patients Receiving Tumor Necrosis Factor Inhibitor Therapy for Concomitant Autoimmune Diseases.
Clin Exp Dermatol, 2018 May 24
Treatment of psoriasis with ustekinumab in a patient with HIV-related Kaposi sarcoma.
N Engl J Med,
Clinical practice. Care of the asplenic patient.
Mediterr J Rheumatol, 2020 Jun 11
Infections in Patients with Rheumatoid Arthritis in the Era of Targeted Synthetic Therapies.
Clin Infect Dis,
Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease.
Journal of neurovirology, 2018-06
Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event.
Scientific reports, 2017 Aug 10
Analysis of Factors Influencing Diagnostic Accuracy of T-SPOT.TB for Active Tuberculosis in Clinical Practice.
Clin Microbiol Infect, 2018 Feb 07
ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Introduction).
PET Clin, 2020 Feb 11
18F-Fluorodeoxyglucose PET/Computed Tomography in the Diagnosis and Monitoring of Giant Cell Arteritis.
Rheumatology (Oxford), 2022 Jul 22
PET/CT of cranial arteries for a sensitive diagnosis of giant cell arteritis.
Arthritis & rheumatology (Hoboken, N.J.), 2017-10
The Safety and Immunogenicity of Live Zoster Vaccination in Patients With Rheumatoid Arthritis Before Starting Tofacitinib: A Randomized Phase II Trial.
Arthritis Care Res (Hoboken), 2016 Jan
2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.
Alimentary pharmacology & therapeutics, 2022 May 20
Review article: latent tuberculosis in patients with inflammatory bowel diseases receiving immunosuppression-risks, screening, diagnosis and management.
Medicine, 2014 Oct
Intravenous immunoglobulin in the therapeutic armamentarium of systemic lupus erythematosus: a systematic review and meta-analysis.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015-08-01
Histoplasmosis complicating tumor necrosis factor-α blocker therapy: a retrospective analysis of 98 cases.
The Lancet. Neurology, 2009-08
Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment.
The Journal of infection, 2011-11
Norovirus gastroenteritis successfully treated with nitazoxanide.
Alimentary pharmacology & therapeutics, 2006 Nov 15
Nitazoxanide in the treatment of viral gastroenteritis: a randomized double-blind placebo-controlled clinical trial.
Journal of tropical medicine, 2017 Feb 26
Nitazoxanide in Acute Rotavirus Diarrhea: A Randomized Control Trial from a Developing Country.
Lupus, 2014 Jul 30
Serious infections in systemic lupus erythematosus with a focus on pneumococcal infections.
MMWR. Morbidity and mortality weekly report, 2024 Sep 12
Use of 21-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices - United States, 2024.
The American journal of medicine, 2024 Mar 16
The Contribution of 18F FDG PET-CT for the Investigation of Fever of Unknown Origin and Inflammation of Unknown Origin.

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