Pulmonary cryptococcosis mimicking methotrexate pneumonitis.
An 81-year-old man being treated with weekly low dose methotrexate (MTX) for psoriasis was admitted with a 2-month history of cough, shortness of breath and 7% eosinophilia in the peripheral blood. Chest roentgenogram revealed bilateral alveolar and interstitial infiltrates. Although the clinical presentation suggested MTX pneumonitis, a transbronchial lung biopsy established a diagnosis of pulmonary cryptococcosis. Pulmonary cryptococcosis should be included in the list of infectious processes that can mimic MTX pneumonitis.
Law
K F
KF
Department of Medicine, NYVA Medical Center, NY 10010.
Aranda
C P
CP
Smith
R L
RL
Berkowitz
K A
KA
Ittman
M M
MM
Lewis
M L
ML
D000368:Aged; D000369:Aged, 80 and over; D003453:Cryptococcosis / Q000175:diagnosis* / Q000382:microbiology; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D003937:Diagnosis, Differential; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis*; D011565:Psoriasis / Q000188:drug therapy
D008727:Methotrexate