Pneumonitis and multiple pneumonial infections under combined immune-checkpoint inhibition

The introduction of immune checkpoint inhibitors and targeted therapies has revolutionized melanoma treatment. The downside are immune-mediated adverse events which are frequent and require close patient management. We report a case of severe immune-mediated hepatitis and pneumonitis under combined immune-checkpoint inhibitor therapy requiring immunosuppressive therapy. Under immunosuppressive therapy, however, a series of opportunistic infections occurred. It can be challenging to distinguish the signs of immune-mediated adverse events of checkpoint inhibitors and pathogen-mediated inflammation due to overlaps in clinical and laboratory findings. This case has the goal to rise awareness for infectious complications during immunosuppressive therapy needed to address immune-mediated adverse events of checkpoint inhibitors.