Takazono Takahiro, Sawai Toyomitsu, Tashiro Masato, Saijo Tomomi, Yamamoto Kazuko, Imamura Yoshifumi, Miyazaki Taiga, Suyama Naofumi, Izumikawa Koichi, Kakeya Hiroshi, Yanagihara Katsunori, Mukae Hiroshi, Kohno Shigeru
Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Intern Med. 2016;55(19):2877-2880. doi: 10.2169/internalmedicine.55.6969. Epub 2016 Oct 1.
A 35-year-old non-HIV patient developed pulmonary cryptococcosis after the initiation of infliximab. He recovered by fluconazole treatment and completed the therapy for a total of 6 months. However, he experienced a relapse 16 months later during retreatment with infliximab, revealing an interesting clinical course contradicting retreatment. This case also represents the first case of relapsed pulmonary cryptococcosis suspected during treatment with a biologic agent. Both of these aspects generated important clinical questions about the length of pulmonary cryptococcosis treatment and the necessity of introducing a second prophylaxis for such patients.
一名35岁的非HIV患者在开始使用英夫利昔单抗后发生了肺隐球菌病。他通过氟康唑治疗康复，并完成了总共6个月的治疗。然而，16个月后他在再次使用英夫利昔单抗治疗期间复发，呈现出与再次治疗相矛盾的有趣临床过程。该病例也是首例在生物制剂治疗期间疑似复发性肺隐球菌病的病例。这两个方面都引发了关于肺隐球菌病治疗时长以及对此类患者进行二次预防必要性的重要临床问题。
