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CT revealed a large irregular cavitary lesion and later showed compression atelectasis and a major pleural effusion. Despite negative AFB tests initially, cultures ultimately identified MRSA in pleural fluid and Mycobacterium avium from sputum, suggesting atypical infection associated with immunosuppression.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/lung-abscess-as-an-adverse-effect-of-risankizumab/456490/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/lung-abscess-as-an-adverse-effect-of-risankizumab/456490.png","ImageObject",300,407,{"name":92,"@type":93},"awa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What symptoms did the patient develop after starting Risankizumab?","Question",{"text":113,"@type":114},"He presented with pleuritic chest pain, cough, hemoptysis, fever, and myalgias, along with gastrointestinal complaints such as nausea and vomiting.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were tuberculosis and other diagnoses evaluated?",{"text":118,"@type":114},"The clinicians ruled out tuberculosis using three negative acid-fast bacilli samples and two negative Mycobacterium tuberculosis/Rifampin resistance (Xpert MTB/RIF) tests, then relied on imaging and cultures when symptoms persisted.",{"name":120,"@type":111,"acceptedAnswer":121},"What organisms were ultimately identified?",{"text":122,"@type":114},"Pleural fluid culture grew methicillin-resistant Staphylococcus aureus (MRSA), and sputum AFB culture grew Mycobacterium avium three weeks after collection.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},456490,1790765315,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","CASE REPORT     \nLung abscess as an adverse effect of Risankizumab  \nZarif Kazi a, Stuart Jesina, Samir Ghimirea, Toni-Ann Lewisa, Thai Donenfeldb, Kevin Clementsband William Pascalb  \na Internal Medicine, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA; bPulmonary and Critical Care, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA  \nABSTRACT  \nBackground: Risankizumab is used for prolongated duration by patients, necessitating further research to characterize the infectious risks involved.  \nCase Presentation: A 30-year-old man on Risankizumab for psoriasis and alopecia presented with pleuritic chest pain, cough, hemoptysis, fever, and myalgias. Initial computed tomography (CT) scan showed a 4.9 × 7.7 × 6.1 cm irregular cavitary lesion in the medial right lower lobe with thickened walls and surrounding ground-glass opacification. Tuberculosis was ruled out with 3 negative acid-fast bacilli (AFB) samples and 2 negative samples for Mycobacterium tuberculosis and rifampin resistance assay (Xpert MTB/RIF) . Empiric antibiotic therapy was initiated, though the patient remained persistently febrile and tachycardic despite reported symptomatic improvement. A repeat CT scan showed compression atelectasis of the right middle and lower lobes, and a large right pleural effusion with multiple airfluid levels. The patient underwent a video-assisted thoracoscopic surgery (VATS) decortication. Pleural fluid culture grew methicillin-resistant Staphylococcus aureus, and sputum AFB culture from admission grew Mycobacterium avium three weeks after collection. The patient ultimately completed two weeks of oral doxycycline.  \nConclusion: Given the lack of notable risk factors for lung abscess, this case suggests a possible association with Risankizumab, which may have contributed to immunosuppression.  \nARTICLE HISTORY  \nReceived 3 November 2025 Accepted 29 December 2025  \nKEYWORDS  \nLung abscess; Risankizumab; Skyrizi; Mycobacterium avium; pulmonary; infection; MRSA  \nIntroduction  \nRisankizumab, commonly known by its brand name Skyrizi, is a humanized IgG1 monoclonal antibody interleukin-23 (IL-23) inhibitor used in the treatment of moderate-to-severe plaque psoriasis and has recently been approved to treat Crohn’s disease and ulcerative colitis as well [ 1] . It inhibits the interaction between the IL-23 cytokine and its receptor by selectively binding to the p19 subunit of IL-23 . The inhibition of this interaction reduces the release of pro-inflammatory cytokines and modulates the immune response [2] . Although it is well tolerated by most patients, the immunomodulatory effects of the medication can increase susceptibility to certain infections. It is most commonly associated with mild upper respiratory tract infections; however, there is limited data regarding its association with more severe or atypical pulmonary infections [ 1] . It has become increasingly popular since its approval in 2019. The IL-PSO study assessed 5932 treatment courses of IL-inhibitors and showed that Risankizumab was one of the most-prescribed IL-  \ninhibitors, with 977 courses documented and 91.6% of patients on the medication 4 years after initiation [3] . Lung abscesses and pulmonary Mycobacterium avium (M. avium) infections are more commonly seen inpatients with known risk factors such as underlying pulmonary disease, HIV/AIDS, or corticosteroid use [4]. A lung abscess is a localized collection of pus within theparenchyma, which results from an infection, causing necrosis of surrounding tissue and cavity formation. Lung abscesses typically form due to aspiration of oropharyngeal secretions, which is common in individuals with impaired consciousness or swallowing mechanisms [5]. Immunosuppressive medications, particularly corticosteroids, are known to increase the risk of pulmonary infections [6]. Patients on immunosuppressive therapy with concurrent dental infections are also at higher risk. A case report in 2012 described","cbCaijftx4i16XvR","https://ap.wps.com/l/cbCaijftx4i16XvR","pdf",1939906,"English","# Abstract\n# Introduction\n# Case description\n# Conclusion","[{\"question\":\"What symptoms did the patient develop after starting Risankizumab?\",\"answer\":\"He presented with pleuritic chest pain, cough, hemoptysis, fever, and myalgias, along with gastrointestinal complaints such as nausea and vomiting.\"},{\"question\":\"How were tuberculosis and other diagnoses evaluated?\",\"answer\":\"The clinicians ruled out tuberculosis using three negative acid-fast bacilli samples and two negative Mycobacterium tuberculosis/Rifampin resistance (Xpert MTB/RIF) tests, then relied on imaging and cultures when symptoms persisted.\"},{\"question\":\"What organisms were ultimately identified?\",\"answer\":\"Pleural fluid culture grew methicillin-resistant Staphylococcus aureus (MRSA), and sputum AFB culture grew Mycobacterium avium three weeks after collection.\"}]","Lung abscess as an adverse effect of Risankizumab | PDF",1790746221,15]