Fatal pneumocystis carinii pneumonia as a complication of methotrexate in rheumatoid arthritis

Abstract

Low dose methotrexate has been used successfully to treat patients with refractory rheumatoid arthritis. Methotrexate-induced pneumonitis occurs in about 1 to 5% of patients, although opportunistic infections have also been reported. We report a case of fatal pneumocystis carinii pneumonia (PCP) in an otherwise healthy female patient treated with methotrexate for rheumatoid arthritis and review the literature.