Cryptococcal fungemia and Mycobacterium haemophilum cellulitis in a patient receiving ruxolitinib: a case report and literature review.

Background: Ruxolitinib is a novel oral Janus kinase inhibitor that is used for treatment of myeloproliferative diseases. It exhibits potent anti-inflammatory and immunosuppressive effects, and may increase the risk of opportunistic infections. Here, we report a rare case of Cryptococcus neoformans...

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Publicado en:BMC Infectious Diseases Vol. 21; no. 1; pp. 1 - 8
Autores principales: Sayabovorn, Naruemit, Chongtrakool, Piriyaporn, Chayakulkeeree, Methee
Formato: case study research Journal Article
Publicado: BioMed Central 1/7/2021
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Cryptococcal fungemia and Mycobacterium haemophilum cellulitis in a patient receiving ruxolitinib: a case report and literature review.
      aug:
        au:
          Sayabovorn, Naruemit
          Chongtrakool, Piriyaporn
          Chayakulkeeree, Methee
        affil: Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, 10700, Bangkok, Thailand
      sug:
        subj:
          Heterocyclic Compounds Adverse Effects
          Fungemia Microbiology
          Cellulitis Microbiology
          Cryptococcosis Microbiology
          Mycobacterium Infections Drug Therapy
          Bile Acids and Salts Therapeutic Use
          Antiinflammatory Agents, Non-Steroidal Adverse Effects
          Antiinflammatory Agents, Non-Steroidal Therapeutic Use
          Cryptococcosis Diagnosis
          Primary Myelofibrosis Drug Therapy
          Cryptococcus
          Male
          Opportunistic Infections Microbiology
          Heterocyclic Compounds Therapeutic Use
          Amphotericin B Therapeutic Use
          Opportunistic Infections Drug Therapy
          Antifungal Agents Therapeutic Use
          Coinfection Drug Therapy
          Mycobacterium
          Cellulitis Drug Therapy
          Human
          Fungemia Drug Therapy
          Drug Combinations
          Primary Myelofibrosis Complications
          Cryptococcosis Drug Therapy
          Mycobacterium Infections Microbiology
          Aged
          Antibiotics Therapeutic Use
          Aged: 65+ years
          Male
      ab: Background: Ruxolitinib is a novel oral Janus kinase inhibitor that is used for treatment of myeloproliferative diseases. It exhibits potent anti-inflammatory and immunosuppressive effects, and may increase the risk of opportunistic infections. Here, we report a rare case of Cryptococcus neoformans and Mycobacterium haemophilum coinfection in a myelofibrosis patient who was receiving ruxolitinib.Case Presentation: A 70-year-old Thai man who was diagnosed with JAK2V617F-mutation-positive primary myelofibrosis had been treated with ruxolitinib for 4 years. He presented with cellulitis at his left leg for 1 week. Physical examination revealed fever, dyspnea, desaturation, and sign of inflammation on the left leg and ulcers on the right foot. Blood cultures showed positive for C. neoformans. He was prescribed intravenous amphotericin B deoxycholate with a subsequent switch to liposomal amphotericin B due to the development of acute kidney injury. He developed new onset of fever after 1 month of antifungal treatment, and the lesion on his left leg had worsened. Biopsy of that skin lesion was sent for mycobacterial culture, and the result showed M. haemophilum. He was treated with levofloxacin, ethambutol, and rifampicin; however, the patient eventually developed septic shock and expired.Conclusions: This is the first case of C. neoformans and M. haemophilum coinfection in a patient receiving ruxolitinib treatment. Although uncommon, clinicians should be aware of the potential for multiple opportunistic infections that may be caused by atypical pathogens in patients receiving ruxolitinib.
      pubtype: Academic Journal
      doctype:
        case study
        research
        Journal Article
      ougenre: Article
    language: English
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