title: Pneumonia due to Cryptococcus neoformans in a patient receiving infliximab: possible zoonotic transmission from a pet cockatiel.
abstract: The use of humanized antibody against tumor necrosis factor alpha (TNF-alpha) may increase the risk of various opportunistic infections, including tuberculosis and fungal infections. We report a case of cryptococcal pneumonia in a patient who was taking infliximab for rheumatoid arthritis. A temporally related exposure history raised the possibility that our patient acquired the infection from his pet cockatiel. It seems prudent to advise patients receiving infliximab to avoid exposure to pet avian excreta.
authors.affiliation: Division of Microbiology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. shrestr@ccf.org.
authors.forename: Rabin K
authors.initials: RK
authors.lastname: Shrestha
authors.forename: James K
authors.initials: JK
authors.lastname: Stoller
authors.forename: Golara
authors.initials: G
authors.lastname: Honari
authors.forename: Gary W
authors.initials: GW
authors.lastname: Procop
authors.forename: Steven M
authors.initials: SM
authors.lastname: Gordon
mesh_terms: D000368:Aged; D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000935:Antifungal Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003453:Cryptococcosis / Q000188:drug therapy / Q000276:immunology* / Q000635:transmission; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D000069285:Infliximab; D008297:Male; D011014:Pneumonia / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology* / Q000628:therapy; D011563:Psittaciformes / Q000382:microbiology; D016896:Treatment Outcome; D015047:Zoonoses / Q000635:transmission
chemical_list: D000911:Antibodies, Monoclonal; D000935:Antifungal Agents; D018501:Antirheumatic Agents; D015725:Fluconazole; D000069285:Infliximab