Reactivation histoplasmosis after treatment with anti-tumor necrosis factor alpha in a patient from a nonendemic area.
Histoplasma capsulatum (HC) is a thermally dimorphic ascomycete that is a significant cause of respiratory infections (>80%) in endemic areas (Midwest and southeast USA), but infections are rare in non-endemic areas. Most primary HC infections are subclinical or self-limited. While reactivation Histoplasmosis has been reported in the setting of immunosuppression, it remains unclear whether remote primary latent infection represents risk of endogenous reactivation after anti-tumor necrosis factor (TNF)-alpha therapy. We report a case of a patient who developed reactivation Histoplasmosis after receiving anti-TNF-alpha. To our knowledge, this is the first clear report of reactivation of "latent" Histoplasmosis after anti-TNF-alpha therapy.
Jain
Vipul V
VV
Department of Medicine, University of California, San Francisco Fresno Medical Education Program, Fresno, CA 93702, USA. vjain@ucsd.edu
Evans
Timothy
T
Peterson
Michael W
MW
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006660:Histoplasmosis / Q000139:chemically induced*; D006801:Humans; D000069285:Infliximab; D008297:Male; D009894:Opportunistic Infections / Q000139:chemically induced*; D012008:Recurrence; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab