Relapsed Pulmonary Cryptococcosis during Tumor Necrosis Factor α Inhibitor Treatment

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  • Takazono Takahiro
    Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan Second Department of Internal Medicine, Nagasaki University Hospital, Japan
  • Sawai Toyomitsu
    Department of Internal Medicine, Nagasaki Municipal Hospital, Japan
  • Tashiro Masato
    Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Saijo Tomomi
    Second Department of Internal Medicine, Nagasaki University Hospital, Japan
  • Yamamoto Kazuko
    Second Department of Internal Medicine, Nagasaki University Hospital, Japan
  • Imamura Yoshifumi
    Second Department of Internal Medicine, Nagasaki University Hospital, Japan
  • Miyazaki Taiga
    Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan Second Department of Internal Medicine, Nagasaki University Hospital, Japan
  • Suyama Naofumi
    Department of Internal Medicine, Nagasaki Municipal Hospital, Japan
  • Izumikawa Koichi
    Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Kakeya Hiroshi
    Department of Infection Control Science, Graduate School of Medicine, Osaka City University, Japan
  • Yanagihara Katsunori
    Department of Laboratory Medicine, Nagasaki University Hospital, Japan
  • Mukae Hiroshi
    Second Department of Internal Medicine, Nagasaki University Hospital, Japan
  • Kohno Shigeru
    Second Department of Internal Medicine, Nagasaki University Hospital, Japan

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Abstract

<p>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. </p>

Journal

  • Internal Medicine

    Internal Medicine 55 (19), 2877-2880, 2016

    The Japanese Society of Internal Medicine

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