title: Relapsed Pulmonary Cryptococcosis during Tumor Necrosis Factor α Inhibitor Treatment.
abstract: A 35-year-old non-HIV patient developed pulmonary cryptococcosis after the initiation of infliximab. He recovered by fluconazole treatment and completed the therapy for a total of 6 months. However, he experienced a relapse 16 months later during retreatment with infliximab, revealing an interesting clinical course contradicting retreatment. This case also represents the first case of relapsed pulmonary cryptococcosis suspected during treatment with a biologic agent. Both of these aspects generated important clinical questions about the length of pulmonary cryptococcosis treatment and the necessity of introducing a second prophylaxis for such patients.
authors.affiliation: Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takazono
authors.forename: Toyomitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Masato
authors.initials: M
authors.lastname: Tashiro
authors.forename: Tomomi
authors.initials: T
authors.lastname: Saijo
authors.forename: Kazuko
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Imamura
authors.forename: Taiga
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Naofumi
authors.initials: N
authors.lastname: Suyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Izumikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakeya
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy; D003453:Cryptococcosis / Q000188:drug therapy / Q000276:immunology*; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab / Q000276:immunology* / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000935:Antifungal Agents; D014409:Tumor Necrosis Factor-alpha; D015725:Fluconazole; D000069285:Infliximab