Pulmonary cryptococcosis mimicking methotrexate pneumonitis.

Law, K F; Aranda, C P; Smith, R L; Berkowitz, K A; Ittman, M M; Lewis, M L · J Rheumatol · 1993

case_report · Level V

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Abstract

An 81-year-old man being treated with weekly low dose methotrexate (MTX) for psoriasis was admitted with a 2-month history of cough, shortness of breath and 7% eosinophilia in the peripheral blood. Chest roentgenogram revealed bilateral alveolar and interstitial infiltrates. Although the clinical presentation suggested MTX pneumonitis, a transbronchial lung biopsy established a diagnosis of pulmonary cryptococcosis. Pulmonary cryptococcosis should be included in the list of infectious processes that can mimic MTX pneumonitis.

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