Reactivation histoplasmosis after treatment with anti-tumor necrosis factor alpha in a patient from a nonendemic area

Respir Med. 2006 Jul;100(7):1291-3. doi: 10.1016/j.rmed.2005.09.020. Epub 2006 Mar 20.


Histoplasma capsulatum (HC) is a thermally dimorphic ascomycete that is a significant cause of respiratory infections (>80%) in endemic areas (Midwest and southeast USA), but infections are rare in non-endemic areas. Most primary HC infections are subclinical or self-limited. While reactivation Histoplasmosis has been reported in the setting of immunosuppression, it remains unclear whether remote primary latent infection represents risk of endogenous reactivation after anti-tumor necrosis factor (TNF)-alpha therapy. We report a case of a patient who developed reactivation Histoplasmosis after receiving anti-TNF-alpha. To our knowledge, this is the first clear report of reactivation of "latent" Histoplasmosis after anti-TNF-alpha therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / adverse effects*
  • Crohn Disease / drug therapy
  • Gastrointestinal Agents / adverse effects*
  • Histoplasmosis / chemically induced*
  • Humans
  • Infliximab
  • Male
  • Opportunistic Infections / chemically induced*
  • Recurrence
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*


  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab