Chest
Selected ReportsPulmonary Cryptococcosis After Initiation of Anti-Tumor Necrosis Factor-α Therapy
Section snippets
Case Report
A 61-year-old man with a 6-year history of advanced rheumatoid arthritis was admitted to the Veterans Affairs hospital for shortness of breath and anemia. His medications included prednisone, 10 mg/d; methotrexate, 25 mg/wk; and leflunomide, 20 mg/d. He was started on infliximab and received three doses at 3 mg/kg ideal body weight, the last dose being administered 3 weeks prior to presentation.
He denied fever, chills, night sweats, chest pain, and weight loss. He denied any sick contacts or
Discussion
The lung is the site of primary infection with C neoformans. Containment and effective control of this infection requires intact host defenses. Immunosuppression can lead to dissemination to the CNS and reticuloendothelial system. In the absence of effective antifungal therapy, immunocompromised patients with pulmonary cryptococcosis are at an increased risk of dissemination with significant morbidity and mortality.4
TNF-α plays a major role in the generation of cell-mediated immunity to
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Cited by (100)
Infections in the era of immunobiologicals
2024, Anais Brasileiros de DermatologiaFungal Infections Potentiated by Biologics
2020, Infectious Disease Clinics of North AmericaWarfare and defense: The host response to Cryptococcus infection
2018, Fungal Biology ReviewsCitation Excerpt :However, fungal infections have emerged as complications in patients receiving anti-TNF therapy. Moreover, a case report determined the risk of pulmonary cryptococcosis in such patients, highlighting the importance to understand the functions of TNF in the immune response to Cryptococcus (Hage et al., 2003). GM-CSF is an essential cytokine for DC development.
Fungal Infections of Bones and Joints
2016, Kelley and Firestein's Textbook of Rheumatology: Volumes 1-2, Tenth EditionBreakthrough disseminated cryptococcosis during micafungin therapy
2015, Journal of Microbiology, Immunology and Infection
Funding was provided by grant K08 HL04545 to Dr. Knox.