Large Nosocomial Outbreak Associated with a Norwegian Scabies Index Case Undergoing TNF-α Inhibitor Treatment: Management and Control

We describe a large outbreak associated with a crusted (Norwegian) scabies case in an immunocompromised patient following treatment with TNF-α inhibitor (adalimumab) for psoriasis arthritis. The increasing use of TNF-α inhibitors should induce clinicians to consider this serious parasitic infection when evaluating skin rashes in patients receiving biologic therapies. Infect. Control Hosp. Epidemiol. 2015;36(11):1358–1360

[1]  P. Tugwell,et al.  Risk of serious infection in biological treatment of patients with rheumatoid arthritis: a systematic review and meta-analysis , 2015, The Lancet.

[2]  C. Mastroianni,et al.  Atypical presentation of crusted (Norwegian) scabies , 2015, Infection.

[3]  G. Safa,et al.  Crusted scabies complicates etanercept therapy in a patient with severe psoriasis. , 2013, Journal of the American Academy of Dermatology.

[4]  M. Muller,et al.  Rapid control of a scabies outbreak at a tertiary care hospital without ward closure. , 2012, American journal of infection control.

[5]  M. Dougados,et al.  Factors Associated with Severe Skin Infections in Patients Treated with Biologic Therapies for Inflammatory Rheumatic Diseases , 2012, Dermatology.

[6]  M. Battegay,et al.  Scabies Outbreak in an Intensive Care Unit with 1,659 Exposed Individuals—Key Factors for Controlling the Outbreak , 2009, Infection Control & Hospital Epidemiology.

[7]  H. Maltezou,et al.  Nosocomial scabies. , 2007, The Journal of hospital infection.

[8]  B. Adams,et al.  Crusted scabies in a patient being treated with infliximab for juvenile rheumatoid arthritis. , 2005, Journal of the American Academy of Dermatology.

[9]  L. Lettau.  Nosocomial transmission and infection control aspects of parasitic and ectoparasitic diseases. Part III. Ectoparasites/summary and conclusions. , 1991 .

[10]  L. Lettau.  Nosocomial Transmission and Infection Control Aspects of Parasitic and Ectoparasitic Diseases Part III. Ectoparasites/Summary and Conclusions , 1991, Infection Control & Hospital Epidemiology.

[11]  K. Cann.  Principles and practice of infectious disease , 1990 .