Histoplasmosis is the most common endemic mycosis worldwide.
1
Most infections are asymptomatic or self-limited, but some can present with multiorgan
involvement, particularly in individuals with impaired cell-mediated immunity. Although
the occurrence of tumor necrosis factor α inhibitor (TNFi)-related histoplasmosis
is well established, concurring vasculitides such as Behcet's disease are rare and
can create a diagnostic dilemma. We present a patient with Behcet's disease receiving
TNFi therapy who developed disseminated histoplasmosis.To read this article in full you will need to make a payment
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References
- Diagnosis of histoplasmosis in immunosuppressed patients.Curr Opin Infects Dis. 2008; 21: 421-425
- The pathological spectrum of gastrointestinal and hepatic histoplasmosis.Am J Clin Path. 2000; 113: 64-72
- Neutrophilic phlebitis is characteristic of intestinal Behcet's disease and simple ulcer syndrome.Histopathology. 2004; 45: 377-383
- Characteristics, treatment, and long-term outcome of gastrointestinal involvement in Behcetʼs syndrome.Medicine. 2016; 95: e3348
- Endoscopic findings of gastrointestinal involvement in Chinese patients with Behcet's disease.World J Gastroenterol. 2014; 20: 17171-17178
- Granulomatous infectious diseases associated with tumor necrosis factor antagonists.Clin Infect Dis. 2004; 38: 1261-1265
- Histoplasmosis after treatment with anti-tumor necrosis factor-alpha therapy.Am J Respir Crit Care Med. 2003; 167: 1279-1282
- Life-threatening histoplasmosis complicating immunotherapy with tumor necrosis factor alpha antagonists infliximab and etanercept.Arthritis Rheum. 2002; 46: 2565-2570
- Recognition, diagnosis, and treatment of histoplasmosis complicating tumor necrosis factor blocker therapy.Clin Infect Dis. 2010; 50: 85-92
- Histoplasmosis infection in patients with rheumatoid arthritis, 1998-2009.BMC Infect Dis. 2011; 11: 145
- Fungal infections complicating tumor necrosis factor alpha blockade therapy.Mayo Clin Proc. 2008; 83: 181-194
- Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America.Clin Infect Dis. 2007; 45: 807-825
- Histoplasmosis complicating tumor necrosis.Clin Infect Dis. 2015; 61: 409-417
Article info
Publication history
Published online: May 03, 2018
Accepted:
April 4,
2018
Received:
April 4,
2018
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had full access to data during design and drafting of this manuscript. All authors were responsible for conception and design, SS drafted the manuscript, JB revised the article, and JB and DS gave final approval of the manuscript.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
