Mycobacterial Hand Infections Occurring Postoperatively in Patients Treated With Tumor Necrosis Factor-α Inhibitors for Inflammatory Arthritis: Report of Three Cases

Tumor necrosis factor-α inhibitors are potent anti-rheumatic drugs, but there is evidence that the high level of immunosuppression they provide may also lead to a higher risk of infections. At our institution, 3 patients with inflammatory arthritis treated with tumor necrosis factor-α inhibitors developed mycobacterial soft tissue infections after routine hand surgery. All 3 patients required multiple surgical procedures, inpatient hospitalizations, and prolonged antibiotic multidrug therapy to clear the infections.