Fatal pulmonary Mycobacterium xenopi in a patient with rheumatoid arthritis receiving etanercept.

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.