PMID- 18831914
OWN - NLM
STAT- MEDLINE
DCOM- 20081118
LR  - 20170214
IS  - 0394-6320 (Print)
IS  - 0394-6320 (Linking)
VI  - 21
IP  - 3
DP  - 2008 Jul-Sep
TI  - Cryptococcal lymphadenitis as a manifestation of immune reconstitution 
      inflammatory syndrome in an HIV-positive patient: a case report and review of the 
      literature.
PG  - 751-6
AB  - Cryptococcus neoformans infections are typically associated with T-cell 
      deficiencies, including acquired immunodeficiency syndrome (AIDS). Although 
      highly active antiretroviral therapy (HAART) has strongly reduced AIDS-related 
      opportunistic infections, the restoration and reactivation of CD4+ cells can 
      induce an immune reconstitution inflammatory syndrome (IRIS), consisting in a 
      deregulated inflammatory response to latent infectious pathogens and/or to their 
      residual antigens. Cryptococcal lymphadenitis has occasionally been documented in 
      IRIS. Here we report a case of histology- and culture-negative cryptococcal 
      lymphadenitis associated with IRIS in an adult AIDS patient with a history of 
      disseminated cryptococcosis, after the start of fully adherent HAART. Appropriate 
      diagnosis was established on nested-PCR and sequence analysis of the interspacer 
      region 2 of C. neoformans ribosomal DNA, and detection of slow-growing 
      blastospores in enrichment cultures of fine-needle lymph node aspirate. Review of 
      recent literature and our case findings suggest that IRIS-associated cryptococcal 
      lymphadenitis is more likely the flare up of a latent infection rather than an 
      immunopathological response to residual antigen of unviable cryptococci.
FAU - Putignani, L
AU  - Putignani L
FAU - Antonucci, G
AU  - Antonucci G
FAU - Paglia, M G
AU  - Paglia MG
FAU - Vincenzi, L
AU  - Vincenzi L
FAU - Festa, A
AU  - Festa A
FAU - De Mori, P
AU  - De Mori P
FAU - Loiacono, L
AU  - Loiacono L
FAU - Visca, P
AU  - Visca P
LA  - eng
PT  - Case Reports
PT  - Letter
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Int J Immunopathol Pharmacol
JT  - International journal of immunopathology and pharmacology
JID - 8911335
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*etiology
MH  - Adult
MH  - Cryptococcosis/*etiology
MH  - HIV Seropositivity/*complications
MH  - Humans
MH  - Inflammation/*complications
MH  - Lymphadenitis/*etiology
MH  - Male
MH  - Syndrome
RF  - 23
EDAT- 2008/10/04 09:00
MHDA- 2008/11/19 09:00
CRDT- 2008/10/04 09:00
PHST- 2008/10/04 09:00 [pubmed]
PHST- 2008/11/19 09:00 [medline]
PHST- 2008/10/04 09:00 [entrez]
AID - 32 [pii]
AID - 10.1177/039463200802100332 [doi]
PST - ppublish
SO  - Int J Immunopathol Pharmacol. 2008 Jul-Sep;21(3):751-6. doi: 
      10.1177/039463200802100332.