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Published on: February 14, 2011

Coccidioidomycosis pneumonia in a nonendemic area associated with infliximab

Mahmood Dweik1, Bruce A Baethge, Alexander G Duarte

  • 1Division of Allergy, Pulmonary, Immunology, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA.

Southern Medical Journal
|May 31, 2007
PubMed

Insights

Tumor necrosis factor (TNF) inhibitors can increase infection risk in rheumatoid arthritis patients. A case highlights coccidioidomycosis pneumonia from imported dust exposure in a non-endemic area.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Pulmonary Medicine

Background:

  • Tumor necrosis factor (TNF) inhibitors are effective rheumatoid arthritis treatments.
  • TNF inhibitors increase the risk of serious infectious complications.
  • Coccidioidomycosis pneumonia is typically acquired in endemic regions.

Observation:

  • A rheumatoid arthritis patient on infliximab developed coccidioidomycosis pneumonia and ARDS.
  • The patient resided in a non-endemic region near the Texas-Louisiana border.
  • Infection was suspected to stem from imported pulverized rock dust from Arizona.

Findings:

  • This case demonstrates coccidioidomycosis pneumonia in a non-endemic area.
  • Fomite dust exposure is a potential transmission route for TNF inhibitor patients.
  • Successful treatment with antifungal therapy was achieved.

Implications:

  • Physicians should consider coccidioidomycosis in TNF inhibitor patients with pneumonia, regardless of geographic location.
  • Awareness of non-traditional exposure routes like fomite dust is crucial.
  • This highlights the importance of environmental and occupational exposures in opportunistic infections.

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