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Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e318287c720
Case Reports

A Complicated Case of Coccidioidomycosis in a Patient Receiving Tumor Necrosis Factor α Inhibitor Therapy With Infliximab

Smith, Kevin M. MD*; Chawdry, Ani; Shumyak, Lyudmila; Ponnuru, Arun MD; Sandin, Ramon L. MD, MS, FCAP*‡; Greene, John N. MD, FACP*†

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Abstract: Coccidioidomycosis is an endemic fungal disease that can cause a primary pulmonary, progressive pulmonary, or disseminated disease that can be severe in patients on tumor necrosis factor α inhibitors for the treatment of a variety of autoimmune and granulomatous disorders. Here, we report a complicated case of disseminated coccidioidomycosis with rare ocular involvement after a possible immune reconstitution inflammatory syndrome in a 51-year-old man on infliximab for the treatment of rheumatoid arthritis.

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