High incidence of anergy in inflammatory bowel disease patients limits the usefulness of PPD screening before infliximab therapy.

Background & Aims: Reports of tuberculosis (TB) in patients administered infliximab prompted the Food and Drug Administration to recommend that all patients being considered for this therapy be evaluated for the risk for latent TB infection by means of a tuberculin skin test (TST). The aim of this study is to evaluate the utility of a TST as an adequate screen for TB exposure in patients with inflammatory bowel disease (IBD).

Methods: Eighty-two consecutive patients with IBD (Crohn's disease, 70 patients; ulcerative colitis, 4 patients; indeterminate colitis, 8 patients) seen at Cedars-Sinai Medical Center IBD Center (Los Angeles, CA) being treated with or considered for infliximab therapy underwent a standard intradermal purified protein derivative (PPD) TST before or between infusions of infliximab.

Bronchiolitis obliterans organizing pneumonia in a patient with AIDS.

A 35-year-old homosexual man who had a remote history of cocaine abuse presented to the hospital with fever, chills, drenching night sweats, and progressive dyspnea of 3 months' duration. His condition had been diagnosed as AIDS 1 1/2 years before presentation. Multiple blood cultures and serological tests failed to yield an infective etiology.

Fungal sinusitis in patients with AIDS: report of 4 cases and review of the literature.

We report here 3 cases of aspergillus sinusitis in patients with AIDS and the 1st fully described case, to our knowledge, of sinusitis associated with Pseudallescheria boydii in a patient with AIDS. We review the microbiology and pathology of fungal sinusitis in patients with AIDS and the morphologic and clinical features and treatment of P. boydii infection and aspergillus sinusitis.

Pneumocystis carinii in FNA of the thyroid.

We report the diagnosis of Pneumocystis carinii (PC) in a fine-needle aspirate (FNA) from the thyroid of a human immunodeficiency virus infected (HIV+) male receiving aerosolized pentamidine as prophylaxis for Pneumocystis carinii pneumonia (PCP). The clinical diagnosis prior to FNA was multinodular goiter. The patient did not have pulmonary symptoms nor previous diagnosis of PCP at the time of the aspirate diagnosis.