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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*†

Infectious Diseases in Clinical Practice: January 2014 - Volume 22 - Issue 1 - p 60–62
doi: 10.1097/IPC.0b013e318287c720
Case Reports

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.

From the *College of Medicine, University of South Florida; †Division of Infectious Diseases, Moffitt Cancer Center, and ‡Clinical Microbiology and Virology Laboratories, Moffitt Cancer Center, Tampa, FL.

Correspondence to: John N. Greene, MD, FACP, Division of Infectious Diseases, Moffitt Cancer Center, University of South Florida College of Medicine, 12902 Magnolia Dr, FOB-3, Tampa, FL 33612-9497. E-mail:

Ani Chawdry and Lyudmila Shumyak are fourth-year medical students of the University of South Florida College of Medicine.

The authors have no conflicts of interest to disclose.

© 2014 Wolters Kluwer Health, Inc. All rights reserved.