Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump
Tuberculosis is an opportunistic infection with protean clinical manifestations. We describe a case of Ruxolitinib induced miliary tuberculosis presenting as a neck lump. A 78-year-old female presented with a two-month history of right-sided neck lump associated with fever, night sweats, and signifi...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2015/284168 |
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| author | Eamon Shamil David Cunningham Billy L. K. Wong Piyush Jani |
| author_facet | Eamon Shamil David Cunningham Billy L. K. Wong Piyush Jani |
| author_sort | Eamon Shamil |
| collection | DOAJ |
| description | Tuberculosis is an opportunistic infection with protean clinical manifestations. We describe a case of Ruxolitinib induced miliary tuberculosis presenting as a neck lump. A 78-year-old female presented with a two-month history of right-sided neck lump associated with fever, night sweats, and significant weight loss. She had a past medical history that included myelofibrosis, being treated with Ruxolitinib. Examination demonstrated 4 × 4 cm right-sided cervical lymphadenopathy. A chest radiograph showed extensive shadowing in both lungs. CT scan demonstrated perilymphatic nodes in addition to the cervical mass. An ultrasound-guided biopsy of a cervical lymph node demonstrated confirmed Mycobacterium tuberculosis infection. It was hypothesized that use of Ruxolitinib through its selective inhibition of Janus-activated kinases 1 and 2 resulted in immunosuppression and miliary tuberculosis in this patient. The medication was stopped and a 12-month regime of antituberculosis therapy commenced. She remained well at one-year follow-up with resolution of lung involvement. Clinicians should consider tuberculosis as a differential diagnosis for patients presenting with a neck lump, particularly in those taking immunosuppressant medication such as Ruxolitinib. A multidisciplinary approach is needed to promptly treat the tuberculosis and consider discontinuation of Ruxolitinib. |
| format | Article |
| id | doaj-art-88c2a7a9925a45449a6051a47da87842 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-88c2a7a9925a45449a6051a47da878422025-02-03T01:02:56ZengWileyCase Reports in Infectious Diseases2090-66252090-66332015-01-01201510.1155/2015/284168284168Ruxolitinib Associated Tuberculosis Presenting as a Neck LumpEamon Shamil0David Cunningham1Billy L. K. Wong2Piyush Jani3ENT Department, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UKENT Department, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UKENT Department, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UKENT Department, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UKTuberculosis is an opportunistic infection with protean clinical manifestations. We describe a case of Ruxolitinib induced miliary tuberculosis presenting as a neck lump. A 78-year-old female presented with a two-month history of right-sided neck lump associated with fever, night sweats, and significant weight loss. She had a past medical history that included myelofibrosis, being treated with Ruxolitinib. Examination demonstrated 4 × 4 cm right-sided cervical lymphadenopathy. A chest radiograph showed extensive shadowing in both lungs. CT scan demonstrated perilymphatic nodes in addition to the cervical mass. An ultrasound-guided biopsy of a cervical lymph node demonstrated confirmed Mycobacterium tuberculosis infection. It was hypothesized that use of Ruxolitinib through its selective inhibition of Janus-activated kinases 1 and 2 resulted in immunosuppression and miliary tuberculosis in this patient. The medication was stopped and a 12-month regime of antituberculosis therapy commenced. She remained well at one-year follow-up with resolution of lung involvement. Clinicians should consider tuberculosis as a differential diagnosis for patients presenting with a neck lump, particularly in those taking immunosuppressant medication such as Ruxolitinib. A multidisciplinary approach is needed to promptly treat the tuberculosis and consider discontinuation of Ruxolitinib.http://dx.doi.org/10.1155/2015/284168 |
| spellingShingle | Eamon Shamil David Cunningham Billy L. K. Wong Piyush Jani Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump Case Reports in Infectious Diseases |
| title | Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump |
| title_full | Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump |
| title_fullStr | Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump |
| title_full_unstemmed | Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump |
| title_short | Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump |
| title_sort | ruxolitinib associated tuberculosis presenting as a neck lump |
| url | http://dx.doi.org/10.1155/2015/284168 |
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