Article Text

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Fatal pulmonary Mycobacterium xenopi in a patient with rheumatoid arthritis receiving etanercept
  1. Nimrod Maimon1,
  2. James Brunton2,
  3. Adrienne Chan2,
  4. Theodore K Marras3
  1. 1
    Soroka University Medical Center, Beer-Sheva, Beer-Sheva, Beer-Sheva, Israel
  2. 2
    University of Toronto, Toronto, Toronto, Ontario, M5T 2S8, Canada
  3. 3
    Toronto Western Hospital, Respiratory Medicine, 452, 7 East, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
  1. ted.marras{at}


In this case study, a 71 year old man with emphysema and severe rheumatoid arthritis, previously treated with a TNFα receptor antagonist, presented with progressive dyspnoea and weight loss. Thoracic imaging revealed extensive destruction of the left lung and this was associated with positive Mycobacterium xenopi cultures from respiratory samples. Anti-mycobacterial chemoptherapy was poorly tolerated and the patient subsequently died from respiratory failure and generalised wasting.

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  • Competing interests: None.