Fatal Mycobacterium peregrinum pneumonia in refractory polymyositis treated with infliximab

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Abstract
Sir, Polymyositis (PM) and dermatomyositis (DM) are systemic inflammatory disorders affecting skeletal muscles and other organs. PM and DM are considered to be associated with high morbidity and mortality rates, particularly related to infectious complications, which have been described in up to 26% of patients [1]. Recently, opportunistic infections have been reported in 12–21% of PM/DM patients. Many factors have been implicated in this apparently increased frequency of infections in PM/DM, especially immunosuppressive drugs [1, 2]. We report a case of fatal Mycobacterium peregrinum pneumonia in a patient with refractory PM, which occurred shortly after institution of anti-tumour necrosis factor α (anti-TNF-α) therapy.