Invasive pulmonary aspergillosis associated with low dose methotrexate therapy for rheumatoid arthritis: a case report of treatment with itraconazole

Tuber Lung Dis. 1994 Apr;75(2):153-5. doi: 10.1016/0962-8479(94)90046-9.


Opportunistic infections complicating low dose methotrexate therapy are rare, consisting predominantly of Pneumocystis carinii pneumonia. We report a case of invasive pulmonary aspergillosis which developed in a patient being treated for seropositive rheumatoid arthritis with low dose methotrexate (5-7.5 mg weekly) for 8 years. The patient was successfully treated with itraconazole 200 mg daily for 6 months. This case adds to the growing evidence implicating low dose methotrexate with opportunistic infections and should heighten clinical awareness in patients on this treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / drug therapy*
  • Aspergillosis / drug therapy*
  • Aspergillosis / pathology
  • Humans
  • Itraconazole / therapeutic use*
  • Lung / pathology
  • Lung Diseases, Fungal / drug therapy*
  • Male
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects*
  • Opportunistic Infections / drug therapy*
  • Opportunistic Infections / etiology


  • Itraconazole
  • Methotrexate