Infectious disease

Questions discussed in this category

How do you approach management of patients with active RA and recurrent non-severe C.diff?

(Patient with active RA despite hydroxychloroquine)

How do you approach a patient on anti-TNF with positive Quantiferon (previously negative) with negative chest x-ray and no symptoms?

2 Answers 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 biologic initiation in patients with inflammatory arthritis and repeatedly indeterminate Quantiferon?

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?

1 Answer available

What is the antifungal prophylaxis regimen that you use in patients on peritoneal dialysis who are receiving antibiotics?

1 Answer available

What is your approach to BK hemorrhagic cystitis not responding to cidofovir?

1 Answer 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 IVIg and/or cytoreduction for patients with IgM MGUS with reciprocal depression in IgG and recurrent infections?

Infection is not part of the criteria for starting treatment both in UpToDate and in NCCN guidelines.

1 Answer available

Which medications have the lowest risk of tuberculosis reactivation in patients with uncertain tuberculosis history and active rheumatologic disease?

2 Answers available

How do you approach DMARD therapy in patients with rheumatoid arthritis and chronic hepatitis B?

Hepatitis screening labs revealing Hep B ag and core positivity with positive PCR

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

When would you consider checking JC virus prior to initiating biologic therapy?

1 Answer available

How long would you treat with antimycobacterials before starting biologic DMARD in a patient with latent TB and active rheumatoid arthritis?

1 Answer available

In which patients with oncologic or hematologic disorders are you recommending a 3rd dose of mRNA COVID vaccine?

2 Answers available

How would you approach chronic isolated severe non-cyclic neutropenia with negative bone marrow and rheumatologic work-up?

Is there a role for empiric antibiotics if there is history of opportunistic infection?

1 Answer available

How would you manage an active rheumatoid arthritis patient on suppressive antibiotic therapy for ocular HSV who has abnormal liver function tests?

1 Answer available

Do you treat HIV/AIDS-associated CNS vasculitis with antiretrovirals alone or in combination with steroids?

1 Answer available

How would you recommend dosing the MMR or other live vaccines for patients with rheumatoid arthritis on immunosuppressive medications such as anti-TNF alpha therapy?

For example, healthcare workers who require these vaccines for employment

1 Answer available

How do you treat RA in patients with pulmonary mycobacterium avium complex (MAC) infections?

1 Answer available

Are there particular concerns related to the use of B-cell depletion therapies such as rituximab for rheumatic disease during the COVID-19 pandemic?

1 Answer available

How would you manage methotrexate therapy in an active rheumatoid arthritis patient undergoing treatment for latent TB with rifampin?

Do you stop methotrexate or adjust the dose?

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

Which immunosuppressed patients with SLE would benefit from antibiotic prophylaxis to prevent pneumocystis pneumonia?

1 Answer available

Would you hold all immunosuppressive medications for the first month of LTBI treatment, or just biologics?

1 Answer available

How would you attempt to determine the etiology of intracranial hemorrhage in a patient with newly diagnosed lupus and an active viral infection?

1 Answer available

Do you avoid any specific biologic therapies in HIV positive patients?

1 Answer available

Should tuberculosis screening be performed before beginning methotrexate for treatment of rheumatoid arthritis?

1 Answer available

In what situations do you check for HIV status in your workup for inflammatory arthritis?

1 Answer available

What is your approach to dental prophylaxis for patients on biologics?

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, 2012-05

2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in 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.

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008-10

Prophylactic antibiotic usage for Pneumocystis jirovecii pneumonia in patients with systemic lupus erythematosus on cyclophosphamide: a survey of US rheumatologists and the review of literature.

Clin Rheumatol, 2006 Dec 21

Rheumatol Int, 2020 Sep 18

High rates of severe disease and death due to SARS-CoV-2 infection in rheumatic disease patients treated with rituximab: a descriptive study.

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.

Ann Rheum Dis, 2019 Aug 14

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases.

Seminars in hematology, 2013-07

Evaluation and management of patients with isolated neutropenia.

Arthritis Rheum,

Tuberculosis associated with therapy against tumor necrosis factor alpha.

Ann Oncol, 2021 Mar 18

Association of Clinical Factors and Recent Anti-Cancer Therapy with COVID-19 Severity among Patients with Cancer: A Report from the COVID-19 and Cancer Consortium.

Journal of neurovirology, 2018-06

Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event.

Arthritis Care Res (Hoboken), 2021 Jul

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Clin Liver Dis (Hoboken), 2018 Aug 22

Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance.

Urology, 1982-09

Prevention of cyclophosphamide-induced hemorrhagic cystitis.

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2009-03

Intravesicular cidofovir for the management of BK virus-associated cystitis.

Clin Infect Dis, 2005 Jan 21

Ciprofloxacin decreased polyoma BK virus load in patients who underwent allogeneic hematopoietic stem cell transplantation.

Pediatr Transplant, 2014 Sep 08

Successful treatment of hemorrhagic cystitis after hematopoietic stem cell transplantation with intravesical hyaluronic acid.

J Clin Oncol, 2021 Apr 30

Third-Party BK Virus-Specific Cytotoxic T Lymphocyte Therapy for Hemorrhagic Cystitis Following Allotransplantation.

Pediatr Infect Dis J, 2014 Nov

Effective treatment of severe BK virus-associated hemorrhagic cystitis with leflunomide in children after hematopoietic stem cell transplantation: a pilot study.

Bone Marrow Transplant, 2006 Mar

Estrogen as treatment of hemorrhagic cystitis in children and adolescents undergoing bone marrow transplantation.

Perit Dial Int, 2022 Mar

ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment.

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.

Infectious disease

Questions discussed in this category

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