A case report of disseminated histoplasmosis and concurrent cryptococcal meningitis in a patient treated with ruxolitinib

BMC Infect Dis. 2019 Mar 27;19(1):287. doi: 10.1186/s12879-019-3922-6.

Abstract

Background: Ruxolitinib is a highly potent janus kinase inhibitor that places its users at risk for various bacterial infections and viral reactivation. However new reports are also emerging that suggest greater immunosuppression and risk for fungal disease.

Case presentation: We report the case of a 51 year-old veteran from Guam, treated with ruxolitinib for polycythemia vera, who developed disseminated histoplasmosis and concurrent cryptococcal meningitis.

Conclusion: This case draws attention to the degree of immunosuppression that may be seen with this drug and the need for heightened vigilance for opportunistic infections in those treated with inhibitors of janus kinase/signal transducers and activators of transcription (JAK/STAT) such as ruxolitinib.

Keywords: Cryptococcus; Histoplasmosis; Immunosuppression; JAKinhibitor; Ruxolitinib.

Publication types

  • Case Reports

MeSH terms

  • Guam
  • Histoplasmosis / chemically induced*
  • Histoplasmosis / complications
  • Histoplasmosis / pathology
  • Humans
  • Immune Tolerance / drug effects
  • Immunocompromised Host
  • Invasive Fungal Infections / chemically induced*
  • Invasive Fungal Infections / complications
  • Invasive Fungal Infections / pathology
  • Male
  • Meningitis, Cryptococcal / chemically induced*
  • Meningitis, Cryptococcal / complications
  • Meningitis, Cryptococcal / pathology
  • Middle Aged
  • Nitriles
  • Polycythemia Vera / drug therapy*
  • Pyrazoles / adverse effects*
  • Pyrimidines
  • Veterans

Substances

  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib