Orbital cellulitis in a patient receiving infliximab for ankylosing spondylitis

PURPOSE: To describe a case of orbital cellulitis arising in a patient treated with an anti-TNF alpha agent. DESIGN: Single interventional case report. METHODS: A 42-year,old man developed severe unilateral orbital cellulitis while receiving infliximab (Remicade, Centocor) treatment for Ankylosing spondylitis (AS) as part of the open-label phase of a trial conducted at our tertiary referral center. Cultures grew Staphylococcus aureus. RESULTS: Infliximab treatment was stopped and the patient made a full recovery after receiving appropriate antibiotic therapy. Infliximab therapy was resumed after three weeks. CONCLUSIONS: Clinical vigilance is warranted when treating patients with anti-TNF alpha agents as these are associated with a diverse and growing number of ophthalmic complications. Resolved infection does not preclude the use of such agents.