TNF is essential for granuloma formation, which is needed for defending against fungal infections and tuberculosis (TB).4 Reactivation of latent TB is a well-described side effect of anti-TNF therapy.5 In addition, reports of invasive fungal infections, when anti-TNFs became available, led to a black box warning for anti-TNFs.4 However, there have been no large studies examining the risk of specific invasive fungal infections in patients with IBD, particularly among those treated with anti-TNFs compared with corticosteroids. This evidence concerns the gene TNF and inflammatory bowel disease.