A rare case of community-acquired necrotizing pneumonia in a patient treated with adalimumab therapy

Necrotizing pneumonia is a life-threatening complication of community-acquired pneumonia managed in an intensive care setting with a multitude of diagnostic modalities and numerous therapeutic interventions. Pseudomonas aeruginosa remains an extremely uncommon organism known to cause necrotizing pneumonia, and of the cases reported, are almost entirely found in immunocompromised hosts. Here, we report a case of Pseudomonas aeruginosa community-acquired necrotizing pneumonia in a host receiving adalimumab therapy that ultimately was not able to be healed despite targeted antibiotics. Adalimumab is known to immunosuppress patients and increase risk of tuberculosis and fungal disease, but have unclear associations with other infections. This case exemplifies a rare encounter of Pseudomonas aeruginosa necrotizing pneumonia in a patient on adalimumab therapy contracted through the community. Treatment of necrotizing pneumonia in patients on adalimumab therapy does not differ significantly from other cases of non-adalimumab associated necrotizing pneumonia.