title: [Tuberculosis and pneumocystis: an unusual co-infection].
abstract: BACKGROUND
  Modern immunosuppressive therapy may be responsible for toxic, immunologic and infectious pulmonary diseases.
  
  
  METHODS
  We report the case of a 58-year old woman treated for rheumatoid arthritis who received leflunomide, corticosteroids, methotrexate and adalimumab. She developed disseminated tuberculosis, which presented with neurological symptoms (brainstem) and also pneumocystis pneumonia.
  
  
  CONCLUSIONS
  Modern immunosuppressive therapy used to treat inflammatory disorders in connective tissue diseases and in transplantation may induce new respiratory diseases, new patterns of known respiratory diseases or co-infections that are very seldom seen outside the context of HIV. Pulmonologists, rheumatologists, internists and intensivists should be aware of this new spectrum of diseases whose presentation may be atypical.
authors.affiliation: Service de Pneumologie, Hôpital Pasteur, CHU de Nice, 30 Avenue de la Voie-Romaine, BP 1069, 06002 Nice cedex 1, France.
authors.forename: S
authors.initials: S
authors.lastname: Martinez
authors.forename: V
authors.initials: V
authors.lastname: Sellam
authors.forename: S
authors.initials: S
authors.lastname: Marco
authors.forename: C
authors.initials: C
authors.lastname: Sanfiorenzo
authors.forename: F
authors.initials: F
authors.lastname: Macone
authors.forename: C H
authors.initials: CH
authors.lastname: Marquette
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001706:Biopsy; D001933:Brain Stem / Q000473:pathology; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008168:Lung / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009460:Neurologic Examination; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents