TNF and inflammatory bowel disease: Inflammatory bowel disease (IBD) is characterized by pathologic inflammation in the gastrointestinal tract, so logically immunosuppression is the primary treatment modality.1 Tumor necrosis factor-alpha inhibitors (anti-TNFs) are more selective immunosuppressants than corticosteroids and are associated with a lower risk of bacterial infection.2,3 However, the anti-TNF mechanism of action may make patients especially susceptible to invasive fungal infections, a potentially devastating complications of IBD treatment.4