Reactivation of tuberculosis in patient treated with the antifibrotic drug nintedanib.

The novel antifibrotic drugs for idiopathic pulmonary fibrosis give us an opportunity for change the course of the disease. Their usages are expected to rise with the widening of their indications. We report a case of a patient who complains of fatigue breathlessness on exertion, dry cough, and fever up to 38°C while on the antifibrotic drug nintedanib treatment. We proved the reactivation of latent tuberculosis (TB) by microbiology of bronchial lavage. The outpatient died from massive hemoptysis. To our knowledge, we present the first case in the world for reactivation of TB in a patient on treatment with nintedanib. We suggest closer follow-up for patients with a history of TB or living in countries with higher TB prevalence during treatment with antifibrotic drugs.