Disseminated Blastomycosis in a Previously Stable Crohn's Disease Patient on Infliximab Therapy

Abstract

Reactivation of granulomatous diseases is a well-documented risk of biologic therapy. This case highlights a patient well controlled on chronic infliximab therapy, developing symptoms consistent with disease progression. The patient underwent a surgical laparoscopy given concern of small bowel obstruction in which diffuse, peritoneal nodularity was seen. Further staining revealed broad-budding yeast and blastomyces urinary antigen resulted as positive. The patient was treated for disseminated blastomycosis, and his symptoms completely resolved.