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Updated: May 29, 2026
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Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens
Published on: February 14, 2011
Adalimumab-associated pulmonary cryptococcosis
Takashi Iwata1, Teruaki Nagano, Masuhiro Tomita
1Department of Thoracic Surgery, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan. taiwata@kanrou.net
Summary
This case report details the first instance of pulmonary cryptococcosis linked to adalimumab treatment in a rheumatoid arthritis patient. The fungal infection developed despite normal initial tests and persisted after adalimumab withdrawal.
Area of Science:
- Medical Mycology
- Rheumatology
- Pulmonology
Background:
- Adalimumab is a TNF-alpha inhibitor used for rheumatoid arthritis.
- Immunosuppression increases the risk of opportunistic infections.
- Pulmonary infections are a known complication of immunosuppressive therapy.
Observation:
- A 56-year-old female with rheumatoid arthritis developed a pulmonary nodule.
- The patient was on adalimumab, methotrexate, and isoniazid.
- Initial chest imaging and lab tests were unremarkable for infection.
Findings:
- Surgical resection revealed Cryptococcus neoformans fungal infection.
- The pulmonary lesion grew despite adalimumab discontinuation.
- Diagnosis was confirmed via Grocott staining and fungal culture.
Implications:
- Adalimumab may be associated with an increased risk of pulmonary cryptococcosis.
- Early diagnosis and treatment are crucial for managing invasive fungal infections.
- This case highlights the importance of considering fungal infections in patients on immunosuppressants with pulmonary symptoms.
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