Author Archives: Christopher Ma, Richard N. Fedorak, Brendan P. Halloran

Question: A 77-year-old man with ulcerative colitis was admitted to hospital with a 1-month history of recurrent fevers. He had a long-standing history of ulcerative pancolitis nonresponsive to mesalamine and azathioprine. After developing steroid dependence (minimal prednisone requirement 15 mg/d), he was started on infliximab approximately 4 months before admission, completing infliximab induction therapy (0, 2, and 6 weeks at 5 mg/kg) and receiving his first maintenance infusion (5 mg/kg). At presentation, the patient had multiple symptoms, including (1) recurrent daily fevers and chills, (2) severe bloody diarrhea (>15 bowel movements per day) with urge and tenesmus, and (3) subacute dyspnea and hypoxia requiring 4 L/min supplemental oxygen by nasal cannula. Continue reading →