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BMJ Case Rep . Organising pneumonia due to inadequately cleared COVID-19 infection while on rituximab

tetano

Editor, Senior Moderator
BMJ Case Rep


. 2024 Oct 26;17(10):e259153.
doi: 10.1136/bcr-2023-259153. Organising pneumonia due to inadequately cleared COVID-19 infection while on rituximab

Caroline G Olson[SUP] 1 [/SUP], Christian Karime[SUP] 2 [/SUP], Nancy Dawson[SUP] 2 [/SUP]



Affiliations
Abstract

A male patient in his 70s with a history of tobacco use, organising pneumonia and rheumatoid arthritis that had been treated for several years with rituximab currently being treated with tocilizumab, presented with progressively worsening shortness of breath, increasing oxygen requirements and weakness. He had a history of COVID-19 infection 6 months prior to presentation. Initial COVID-19 PCR testing at presentation was negative. Bronchoalveolar lavage was positive for COVID-19 but negative for spike antibodies. It was thought that he did not clear his prior COVID-19 infection due to his immunocompromised state while taking rituximab. On recommendation of infectious disease, he was treated with a prolonged course of nirmatrelvir/ritonavir, remdesivir and corticosteroids with significant symptom improvement.

Keywords: COVID-19; Drugs: musculoskeletal and joint diseases; Pneumonia (infectious disease); Pneumonia (respiratory medicine).

 
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