What is the treatment for coccidioidomycosis in patients on antitumor necrosis factor therapy?

Updated: Aug 27, 2019
  • Author: Duane R Hospenthal, MD, PhD, FACP, FIDSA, FASTMH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Although biologic agents used to treat rheumatoid arthritis and other autoimmune diseases are usually linked to reactivation of tuberculosis and histoplasmosis, a study found that out of 13 patients with rheumatologic disease in an endemic area, all 12 treated with infliximab developed coccidioidomycosis while on therapy. Of these, one third developed disseminated disease. Given the high risk of developing coccidioidomycosis, empiric therapy should be considered before starting infliximab therapy, if serology findings for Coccidioides are positive. [36]


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