Disseminated mucormycosis and orbital ischaemia in combination immunosuppression with a tumour necrosis factor alpha inhibitor

Clin Exp Ophthalmol. 2007 Apr;35(3):275-80. doi: 10.1111/j.1442-9071.2007.01458.x.

Abstract

Disseminated mucormycosis, with pulmonary and cerebral angioinvasive disease, developed in a 65-year-old woman with rheumatoid arthritis being treated with combination immunosuppression including adalimumab. Clinical presentation included progressive orbital ischaemia. To the best of the authors' knowledge, this is the first reported case of disseminated mucormycosis in a patient treated with a tumour necrosis factor inhibitor. Important pathophysiological factors are considered.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab
  • Aged
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Arthritis, Rheumatoid / drug therapy
  • Brain Diseases / diagnosis
  • Brain Diseases / etiology
  • Drug Therapy, Combination
  • Fatal Outcome
  • Female
  • Fungemia / diagnosis
  • Fungemia / etiology*
  • Humans
  • Immunosuppression Therapy
  • Immunosuppressive Agents / therapeutic use*
  • Ischemia / diagnosis
  • Ischemia / etiology*
  • Lung Diseases, Fungal / diagnosis
  • Lung Diseases, Fungal / etiology
  • Magnetic Resonance Angiography
  • Mucormycosis / diagnosis
  • Mucormycosis / etiology*
  • Ophthalmic Artery / pathology
  • Orbit / blood supply*
  • Radiography, Thoracic
  • Tomography, X-Ray Computed
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Adalimumab