Disseminated Coccidioidomycosis Treated with Interferon-γ and Dupilumab

The New England Journal of Medicine
Monica TsaiManish J Butte

Abstract

We describe a case of life-threatening disseminated coccidioidomycosis in a previously healthy child. Like most patients with disseminated coccidioidomycosis, this child had no genomic evidence of any known, rare immune disease. However, comprehensive immunologic testing showed exaggerated production of interleukin-4 and reduced production of interferon-γ. Supplementation of antifungal agents with interferon-γ treatment slowed disease progression, and the addition of interleukin-4 and interleukin-13 blockade with dupilumab resulted in rapid resolution of the patient's clinical symptoms. This report shows that blocking of type 2 immune responses can treat infection. This immunomodulatory approach could be used to enhance immune clearance of refractory fungal, mycobacterial, and viral infections. (Supported by the Jeffrey Modell Foundation and the National Institutes of Health.).

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Citations

Oct 13, 2020·Frontiers in Cellular and Infection Microbiology·Muluneh Ademe
Nov 27, 2020·Global Pediatric Health·Alisha K Bajwa, Chokechai Rongkavilit
Feb 19, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Daniel K YeohJoshua Osowicki
May 7, 2021·Case Reports in Infectious Diseases·Olufemi AdurojaAngelica Padilla
May 22, 2021·Infectious Disease Clinics of North America·Derek J Bays, George R Thompson
Jun 12, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Daniel K YeohJoshua Osowicki
Aug 24, 2021·The Lancet Infectious Diseases·Thomas DerungsThomas Schneider
Dec 27, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Bob GengBenjamin Ortiz

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An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

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