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Table 2 Literature review for reported cases of cryptococcal infection in patients receiving ruxolitinib

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

Author [Year] Patient Gender/Age Clinical diagnosis Underlying disease(s) Ruxolitinib duration Symptoms Laboratory findings Imaging Organism/site Treatment Outcome
Wysham N, et al. [2013] [4] 1 Male/66 Pneumonia Polycythemia vera and myelofibrosis 18 months Dyspnea, cough, and intermittent fever - Mild leukocytosis
- Serum cryptococcal Ag 1:4
Multifocal consolidations with surrounding ground glass opacities Cryptococcus neoformans (BAL) - Oral fluconazole
(5 months)
- Discontinue ruxolitinib
Survived
Chen C, et al. [2016] [10] 2 Female/69 Meningoencephalitis Myelofibrosis 46 months Fever, alteration of consciousness - Blood chemistry: NA
- CSF cryptococcal Ag 1:512
Normal brain imaging - Cryptococcus neoformans
(Fungal CSF culture)
- Amphotericin B and high-dose fluconazole Survived
Hirano A, et al. [2017] [5] 3 Male/79 Pulmonary nodules Primary myelofibrosis 6 months Asymptomatic - Normal CBC
- Serum cryptococcal Ag 1:8
Multiple pulmonary nodules Cryptococcus spp. (TBBx) - Oral voriconazole
(5 months)
- Discontinue ruxolitinib
Survived
Liu J, et al. [2018] [9] 4 Male/71 Pericardial effusion Chronic myelomonocytic leukemia NA Cardiac tamponade - Marked leukocytosis
- AKI, metabolic acidosis, liver dysfunction
Bilateral pulmonary infiltrations (CXR) Cryptococcus neoformans
(Blood and pericardial culture)
- IV micafungin
- IV fluconazole
Died
Prakash K and Richman D [2019] [6] 5 Male/51 Meningitis Polycythemia vera 18 months Fever, lethargy, headache, weight loss, oral ulcer - AKI, hyponatremia, elevated ALP
- CSF pleocytosis
- Serum cryptococcal Ag 1:128
- Innumerable rim enhancing lesions at the gray-white junction
- Retrocardiac mass
- Cryptococcus neoformans (Fungal CSF culture)
- Histoplasma capsulatum
- Amphotericin B and flucytosine
- Isavuconazole
- Discontinue ruxolitinib
Survived
Tsukui D, et al. [2020] [11] 6 Male/76 Meningitis Myelofibrosis 5 months Fever, alteration of consciousness - Anemia with normal WBC and platelet
- CSF pleocytosis
- Serum cryptococcal Ag positive (qualitative)
Normal brain imaging - Cryptococcus neoformans
(CSF- quantitative assay titers positive 1:16)
- Amphotericin B 37 days, then oral fluconazole
- Discontinue ruxolitinib
Survived
  1. Abbreviations: Ag Antigen, AKI Acute kidney injury, ALP Alkaline phosphatase, BAL Bronchoalveolar lavage, CBC Complete blood count, CSF Cerebrospinal fluid, CXR Chest X-ray, IV Intravenous, NA Not available, TBBx Transbronchial biopsy, WBC White blood cell
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