Case of pulmonary cryptococcosis which developed in a patient receiving abatacept therapy for rheumatoid arthritis

A 59-year-old woman who had been receiving abatacept therapy for rheumatoid arthritis was noted to have multiple nodules in both lungs on routine chest X-ray films. Chest computed tomography (CT) revealed multiple nodules with small cavities in both lung fields. The Cryptococcus neoformans antigen was detected from her serum and bronchial lavage fluids, indicating a diagnosis of pulmonary cryptococcosis. Abatacept was discontinued, and antifungal treatment with fluconazole was started. The lung nodules gradually shrank, and the cavities disappeared. To the best of our knowledge, we describe the first case of pulmonary cryptococcosis associated with abatacept therapy.