Pulmonary Coccidioidomycosis in a Ruxolitinib-Treated Polycythemia Vera Patient: A Case Study and Literature Review

This case report explores the epidemiology and clinical implications of coccidioidomycosis (Valley fever), with a focus on cases involving the immunosuppressive agent ruxolitinib (RUX) in patients with polycythemia vera (PV). The incidence of coccidioidomycosis has increased in the past decade in endemic regions, particularly in immunocompromised individuals. RUX, a Janus-associated kinase 1/2 (JAK1/2) inhibitor used in PV treatment, has been associated with various infections, but its link to coccidioidomycosis remains underexplored. We present a rare case of coccidioidomycosis in a PV patient receiving RUX, highlighting the potential risks associated with this therapy. Our analysis suggests a possible increased risk of coccidioidomycosis in RUX-treated patients, especially in endemic areas, which is supported by retrospective cohort data. This case underscores the importance of heightened vigilance and consideration of prophylactic measures in patients receiving RUX, particularly in regions where coccidioidomycosis is prevalent. Understanding these associations can inform clinical management strategies and improve patient outcomes.