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Table 2 Clinical characteristics and treatment of 26 patients with rheumatoid arthritis who developed histoplasmosis

From: Histoplasmosis infection in patients with rheumatoid arthritis, 1998-2009

Patient number Age/Sex Anti-TNF agent Time to infection from initiation of anti-TNF agents (months) Other therapy Site of infection Diagnosis* Treatment
1 68/M Adalimumab 48 Methotrexate, Prednisone Lung Serology Itraconazole 3 months
2 60/M Adalimumab 3 Hydroxychloroquine, Prednisone, Leflunomide Lung Serology Itraconazole > 12 months
3 64/M Adalimumab 2 None Lung Pathology (lung) Amphotericin 2 weeks, voriconazole 3 months
4 62/M Adalimumab 12 Methotrexate, Prednisone Lung, liver Culture (lung), pathology (lung), serology, urine antigen Amphotericin 2 weeks, itraconazole > 12 months
5 47/F Adalimumab 4 Methotrexate, Prednisone Lung Pathology (sputum), serology, urine antigen Fluconazole 12 months
6 72/F Adalimumab 15 Methotrexate Lung, bone marrow, fungemia Culture (sputum, bone marrow, blood), pathology (lung), serology, urine antigen Amphotericin 2 weeks, voriconazole 10 weeks, itraconazole 12 months
7 47/F Adalimumab 33 Methotrexate Lung Culture (sputum), serology, urine antigen Itraconazole 16 weeks, transition to fluconazole 12 weeks (6 months total)
8 37/F Etanercept 3 Methotrexate, Hydroxychloroquine Lung Serology No treatment
9 47/F Etanercept 2 Methotrexate Lung Serology Itraconazole 1 week Voriconazole 12 months
10 59/M Infliximab 12 Methotrexate, Prednisone, Leflunomide Liver, fungemia Culture (blood), pathology (liver), serology, urine antigen Amphotericin 8 weeks, voriconazole 6 months transition to itraconazole > 12 months
11 73/F Infliximab 24 Methotrexate, Prednisone Bone marrow, fungemia Culture (blood, bone marrow), serology Itraconazole 3 months (follow up elsewhere)
12 32/M Infliximab 18 Methotrexate, Hydroxychloroquine, Prednisone Lung Culture (sputum), pathology (lung), serology, urine antigen Amphotericin 2 weeks, itraconazole > 12 months
13 68/F Infliximab 36 Prednisone Lung, small bowel Culture (sputum, small bowel, peritoneum), pathology (small bowel) serology, urine antigen Amphotericin 4 weeks, Itraconazole indefinitely
14 64/M Infliximab 132 Azathioprine, Prednisone Lung Pathology (lung), serology No treatment
15 53/F Infliximab 56 Methotrexate Lung Serology, urine antigen Voriconazole 1 week, Itraconazole 12 months
16 52/M None N/A Methotrexate, Prednisone Lung, bone marrow, fungemia Culture (blood), pathology (bone marrow), serology, urine antigen Amphotericin 1 week, Itraconazole 6 months
17 68/M None N/A Methotrexate, Prednisone, Leflunomide Lung Serology Itraconazole 5 months
18 68/M None N/A Methotrexate, Prednisone Lung, bone marrow Culture (sputum), pathology (lung, bone marrow), serology, urine antigen Itraconazole 12 months
19 70/M None N/A Methotrexate, Prednisone, Leflunomide Fungemia Culture (blood) Itraconazole 6 months
20 63/M None N/A Methotrexate, Prednisone Lung, Spleen Culture (lung, sputum), serology, urine antigen Itraconazole > 12 months
21 62/F None N/A Methotrexate Lung, fungemia Culture (blood), serology Amphotericin 2 weeks, itraconazole 12 months
22 78/M None N/A Methotrexate, Prednisone Lung Culture (sputum), serology, urine antigen Itraconazole 6 months
23 68/M None N/A Methotrexate, Leflunomide, Minocycline Lung, fungemia Culture (blood), serology, urine antigen Amphotericin 2 weeks, Itraconazole 12 months
24 35/F None N/A None Lung Pathology (lung), serology Itraconazole 3 months
25 75/M None N/A Methotrexate, Hydroxychloroquine Lung Pathology (lung) Itraconazole 6 weeks
26 45/F None N/A Methotrexate, Hydroxychloroquine Lung, liver serology Itraconazole 12 months
  1. F = female; M = male; N/A = not applicable.
  2. *See Methods for description of tests