Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib Therapy
Akarawut Kasemchaiyanun,1 Thitiporn Suwatanapongched,2 Pimpin Incharoen,3 Sirithep Plumworasawat,3 Jackrapong Bruminhent4 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Division of Diagnosti...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-09-01
|
| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/combined-pulmonary-tuberculosis-with-pulmonary-and-pleural-cryptococco-peer-reviewed-fulltext-article-IDR |
| _version_ | 1818912143200747520 |
|---|---|
| author | Kasemchaiyanun A Suwatanapongched T Incharoen P Plumworasawat S Bruminhent J |
| author_facet | Kasemchaiyanun A Suwatanapongched T Incharoen P Plumworasawat S Bruminhent J |
| author_sort | Kasemchaiyanun A |
| collection | DOAJ |
| description | Akarawut Kasemchaiyanun,1 Thitiporn Suwatanapongched,2 Pimpin Incharoen,3 Sirithep Plumworasawat,3 Jackrapong Bruminhent4 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 3Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 4Division of Infectious Disease, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Jackrapong BruminhentDivision of Infectious Disease, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Ramathibodi Hospital, Ratchathewi, Bangkok, ThailandTel/Fax +66 2 201 1581Email jackrapong.brm@mahidol.ac.th; jbruminhent@gmail.comAbstract: With an advance in therapy, there are increasing emerging and re-emerging opportunistic infections among patients with hematologic conditions and malignancy. Herein, we present a 56-year-old woman with primary myelofibrosis who developed combined tuberculosis (TB) and cryptococcosis with extensive pulmonary, pleural, and nodal involvement during ruxolitinib therapy. Marked clinical and radiologic improvements were undoubtedly evident after receiving anti-TB and antifungal therapies and pleural drainage. Hence, the presence of atypical clinical and radiologic manifestations and incomplete responses, despite receiving adequate antimicrobial treatment, should raise concerns regarding the combined emerging and re-emerging opportunistic infections and the possibility of unusual radiologic manifestations of cryptococcosis in a ruxolitinib-treated patient.Keywords: ruxolitinib, Janus kinase inhibitor, cryptococcosis, tuberculosis, pleural effusion, treatment, primary myelofibrosis |
| first_indexed | 2024-12-19T23:09:54Z |
| format | Article |
| id | doaj.art-dc985681020145da80377002d1f7275f |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-19T23:09:54Z |
| publishDate | 2021-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-dc985681020145da80377002d1f7275f2022-12-21T20:02:15ZengDove Medical PressInfection and Drug Resistance1178-69732021-09-01Volume 143901390569030Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib TherapyKasemchaiyanun ASuwatanapongched TIncharoen PPlumworasawat SBruminhent JAkarawut Kasemchaiyanun,1 Thitiporn Suwatanapongched,2 Pimpin Incharoen,3 Sirithep Plumworasawat,3 Jackrapong Bruminhent4 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 3Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 4Division of Infectious Disease, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Jackrapong BruminhentDivision of Infectious Disease, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Ramathibodi Hospital, Ratchathewi, Bangkok, ThailandTel/Fax +66 2 201 1581Email jackrapong.brm@mahidol.ac.th; jbruminhent@gmail.comAbstract: With an advance in therapy, there are increasing emerging and re-emerging opportunistic infections among patients with hematologic conditions and malignancy. Herein, we present a 56-year-old woman with primary myelofibrosis who developed combined tuberculosis (TB) and cryptococcosis with extensive pulmonary, pleural, and nodal involvement during ruxolitinib therapy. Marked clinical and radiologic improvements were undoubtedly evident after receiving anti-TB and antifungal therapies and pleural drainage. Hence, the presence of atypical clinical and radiologic manifestations and incomplete responses, despite receiving adequate antimicrobial treatment, should raise concerns regarding the combined emerging and re-emerging opportunistic infections and the possibility of unusual radiologic manifestations of cryptococcosis in a ruxolitinib-treated patient.Keywords: ruxolitinib, Janus kinase inhibitor, cryptococcosis, tuberculosis, pleural effusion, treatment, primary myelofibrosishttps://www.dovepress.com/combined-pulmonary-tuberculosis-with-pulmonary-and-pleural-cryptococco-peer-reviewed-fulltext-article-IDRruxolitinibjanus kinase inhibitorcryptococcosistuberculosispleural effusiontreatmentprimary myelofibrosis |
| spellingShingle | Kasemchaiyanun A Suwatanapongched T Incharoen P Plumworasawat S Bruminhent J Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib Therapy Infection and Drug Resistance ruxolitinib janus kinase inhibitor cryptococcosis tuberculosis pleural effusion treatment primary myelofibrosis |
| title | Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib Therapy |
| title_full | Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib Therapy |
| title_fullStr | Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib Therapy |
| title_full_unstemmed | Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib Therapy |
| title_short | Combined Pulmonary Tuberculosis with Pulmonary and Pleural Cryptococcosis in a Patient Receiving Ruxolitinib Therapy |
| title_sort | combined pulmonary tuberculosis with pulmonary and pleural cryptococcosis in a patient receiving ruxolitinib therapy |
| topic | ruxolitinib janus kinase inhibitor cryptococcosis tuberculosis pleural effusion treatment primary myelofibrosis |
| url | https://www.dovepress.com/combined-pulmonary-tuberculosis-with-pulmonary-and-pleural-cryptococco-peer-reviewed-fulltext-article-IDR |
| work_keys_str_mv | AT kasemchaiyanuna combinedpulmonarytuberculosiswithpulmonaryandpleuralcryptococcosisinapatientreceivingruxolitinibtherapy AT suwatanapongchedt combinedpulmonarytuberculosiswithpulmonaryandpleuralcryptococcosisinapatientreceivingruxolitinibtherapy AT incharoenp combinedpulmonarytuberculosiswithpulmonaryandpleuralcryptococcosisinapatientreceivingruxolitinibtherapy AT plumworasawats combinedpulmonarytuberculosiswithpulmonaryandpleuralcryptococcosisinapatientreceivingruxolitinibtherapy AT bruminhentj combinedpulmonarytuberculosiswithpulmonaryandpleuralcryptococcosisinapatientreceivingruxolitinibtherapy |