Histoplasmosis infection in patients with rheumatoid arthritis, 1998-2009

Timothy C. Olson, Tim Bongartz, Cynthia Crowson, Glenn D. Roberts, Robert Orenstein, Eric Lawrence Matteson

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Patients with rheumatic diseases including rheumatoid arthritis (RA) are at increased risk for infections related to both the disease and its treatments. These include uncommonly reported infections due to histoplasmosis.Methods: Medical record review of all patients with a diagnosis of RA who developed new histoplasmosis infection in an endemic region between Jan 1, 1998 and Jan 30, 2009 and who were seen at Mayo Clinic in Rochester, Minnesota was performed.Results: Histoplasmosis was diagnosed in 26 patients. Most patients were on combination therapies; 15 were on anti-tumor necrosis factor (anti-TNF) agents, 15 on corticosteroids and 16 on methotrexate. Most received more than 6 months of itraconazole and/or amphotericin treatment. Two patients died of causes unrelated to histoplasmosis. Anti-TNF treatment was restarted in 4/15 patients, with recurrence of histoplasmosis in one.Conclusions: In this largest single center series of patients with RA and histoplasmosis in the era of immunomodulatory therapy, we found that most patients had longstanding disease and were on multiple immunomodulatory agents. Most cases were pulmonary; typical signs and symptoms of disease were frequently lacking.

Original languageEnglish (US)
Article number145
JournalBMC Infectious Diseases
Volume11
DOIs
StatePublished - May 23 2011

Fingerprint

Histoplasmosis
Rheumatoid Arthritis
Infection
Itraconazole
Immunomodulation
Amphotericin B
Therapeutics
Rheumatic Diseases
Methotrexate
Signs and Symptoms
Medical Records
Adrenal Cortex Hormones
Tumor Necrosis Factor-alpha
Recurrence
Lung

Keywords

  • Histoplasmosis
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Histoplasmosis infection in patients with rheumatoid arthritis, 1998-2009. / Olson, Timothy C.; Bongartz, Tim; Crowson, Cynthia; Roberts, Glenn D.; Orenstein, Robert; Matteson, Eric Lawrence.

In: BMC Infectious Diseases, Vol. 11, 145, 23.05.2011.

Research output: Contribution to journalArticle

Olson, Timothy C. ; Bongartz, Tim ; Crowson, Cynthia ; Roberts, Glenn D. ; Orenstein, Robert ; Matteson, Eric Lawrence. / Histoplasmosis infection in patients with rheumatoid arthritis, 1998-2009. In: BMC Infectious Diseases. 2011 ; Vol. 11.
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