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Immunomodulatory treatments for autoimmune diseases further complicate infection risks. This is the first case of a severe Pseudomonas aeruginosa pneumonia in an 86-year-old rheumatoid arthritis patient on baricitinib and prednisone. Initially admitted after a fall, she showed no respiratory symptoms but had a chest x-ray revealing extensive infiltrative consolidation. Sputum analysis confirmed the pneumonia, which was successfully treated with antibiotics. Following the resolution of the infection, the immunomodulatory therapy could be safely reintroduced. The case underscores the critical need for comprehensive diagnostic evaluation in older adults on immunomodulatory therapy, emphasizing that subtle, non-respiratory symptoms can mask serious infections and require heightened clinical suspicion.<\/jats:p>","DOI":"10.4235\/agmr.24.0191","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T23:47:56Z","timestamp":1747957676000},"page":"414-417","update-policy":"https:\/\/doi.org\/10.4235\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Community-Acquired Pneumonia with Pseudomonas aeruginosa in a Geriatric Patient with Rheumatoid Arthritis under Baricitinib Treatment"],"prefix":"10.4235","volume":"29","author":[{"given":"Eva","family":"Grundmann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4552-7191","authenticated-orcid":true,"given":"Ghazala","family":"Gohar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Meier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertram","family":"Feil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gagesch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2749","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2024.103581"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/s2665-9913(20)30032-1"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221276"},{"key":"ref4","volume-title":"Olumiant [Internet]","year":"c2024"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1513\/annalsats.201906-459oc"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00797.x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-1393"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.4235\/agmr.2017.21.4.158"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2010.01819.x"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2016.02.012"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.01510"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2022-222335"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/1744666x.2022.2014323"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-10777-w"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa117"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2022.152120"}],"container-title":["Annals of Geriatric Medicine and Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-agmr.org\/upload\/pdf\/agmr-24-0191.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-agmr.org\/journal\/view.php?doi=10.4235\/agmr.24.0191","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-agmr.org\/upload\/pdf\/agmr-24-0191.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T08:31:21Z","timestamp":1759134681000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-agmr.org\/journal\/view.php?doi=10.4235\/agmr.24.0191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"URL":"https:\/\/doi.org\/10.4235\/agmr.24.0191","relation":{},"ISSN":["2508-4798","2508-4909"],"issn-type":[{"value":"2508-4798","type":"print"},{"value":"2508-4909","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]},"assertion":[{"value":"2024-12-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-19","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}