Concomitant disseminated histoplasmosis and disseminated tuberculosis after tumor necrosis factor inhibitor treatment: a case report

BMC Infectious Diseases

Case Report

Aracelis Nieves-Rodriguez¹  Juan E. Muñoz-Oca²  Lemuel Martínez-Bonilla³  Martha L. Villarreal Morales⁴ 

[1] ANR: Department of Family Medicine, Manatí Medical Center, P.O Box 1142, 00674, Manatí, PR, USA;JEMO: Family Medicine Residency Program, Manatí Medical Center, P.O Box 1142, 00674, Manatí, PR, USA;LMB: Department of Internal Medicine /Infectious diseases, Manatí Medical Center, P.O Box 1142, 00674, Manatí, PR, USA;MLVM: Department of Medical Education, Manatí Medical Center, P.O Box 1142, 00674, Manatí, PR, USA;

关键词: Histoplasmosis;    Tuberculosis;    Co-infection;    TNF-α inhibitors;    Adalimumab;    Case report;   

DOI  :  10.1186/s12879-016-2097-7

 received in 2016-08-13, accepted in 2016-12-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTumor necrosis factor antagonist inhibitors have transformed the approach to patients with severe autoimmune conditions, such as rheumatoid arthritis. Although the therapy can be highly effective, TNF-α inhibitors are associated with an increased risk of opportunistic infections.Case presentationHere, we report a case of concomitant disseminated histoplasmosis and tuberculosis in a 65-year-old female with rheumatoid arthritis treated with TNF-α inhibitor. Both conditions can be found in disseminated form in immunosuppressed hosts, but co-infection is rare with only a few cases having been reported, to our knowledge, all in HIV patients.ConclusionsThis case posed a considerable challenge for diagnosis and treatment due to the unusual disseminated co-infection, the overlapping symptoms, and the interactions between medications.

【 授权许可】

CC BY   
© The Author(s). 2017