[Tuberculosis and pneumocystis: an unusual co-infection]
S Martinez1, V Sellam, S Marco
1Service de Pneumologie, Hôpital Pasteur, CHU de Nice, 30 Avenue de la Voie-Romaine, BP 1069, 06002 Nice cedex 1, France.
Introduction:
Modern immunosuppressive therapy may be responsible for toxic, immunologic and infectious pulmonary diseases.
Case Report:
We report the case of a 58-year old woman treated for rheumatoid arthritis who received leflunomide, corticosteroids, methotrexate and adalimumab. She developed disseminated tuberculosis, which presented with neurological symptoms (brainstem) and also pneumocystis pneumonia.
Conclusion:
Modern immunosuppressive therapy used to treat inflammatory disorders in connective tissue diseases and in transplantation may induce new respiratory diseases, new patterns of known respiratory diseases or co-infections that are very seldom seen outside the context of HIV. Pulmonologists, rheumatologists, internists and intensivists should be aware of this new spectrum of diseases whose presentation may be atypical.
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