Disseminated blastomycosis in a patient with polycythemia vera on ruxolitinib

Kristen Zeitler; Ripal Jariwala; Sally Alrabaa; Chakrapol Sriaroon

doi:10.1136/bcr-2021-243694

Disseminated blastomycosis in a patient with polycythemia vera on ruxolitinib

BMJ Case Rep. 2021 Nov 1;14(11):e243694. doi: 10.1136/bcr-2021-243694.

Authors

Kristen Zeitler¹, Ripal Jariwala², Sally Alrabaa³, Chakrapol Sriaroon⁴

Affiliations

¹ Department of Pharmacy, Tampa General Hospital, Tampa, Florida, USA.
² Department of Pharmacy, University of California San Francisco, San Francisco, California, USA.
³ Division of Infectious Diseases and International Medicine, Department of Internal Medicine, University of South Florida, Tampa, Florida, USA.
⁴ Pulmonary/Critical Care, University of South Florida, Tampa, Florida, USA csriaro@health.usf.edu.

Abstract

Ruxolitinib (RUX) is a kinase inhibitor used in the treatment of various medical conditions and its mechanism of action involves suppression of the immune system. While beneficial in treatment of polycythemia vera, myelofibrosis and other indications, it can also increase a patient's susceptibility to various infections, including bacterial, viral and fungal. We present a case of a patient being treated with RUX who presented with a disseminated fungal infection. This case emphasises the need for vigilance of endemic fungal infections in individuals who are on RUX therapy.

Keywords: infections; malignant disease and immunosuppression.

Publication types

Case Reports

MeSH terms

Blastomycosis*
Humans
Nitriles
Polycythemia Vera* / complications
Polycythemia Vera* / drug therapy
Primary Myelofibrosis* / complications
Primary Myelofibrosis* / drug therapy
Pyrazoles / therapeutic use
Pyrimidines

Substances

Nitriles
Pyrazoles
Pyrimidines
ruxolitinib