PMID- 24108453
OWN - NLM
STAT- MEDLINE
DCOM- 20140512
LR  - 20140326
IS  - 1758-1052 (Electronic)
IS  - 0956-4624 (Linking)
VI  - 25
IP  - 5
DP  - 2014 Apr
TI  - Symptomatic relapse of HIV-associated cryptococcal meningitis: recurrent 
      cryptococcal meningitis or Cryptococcus-related immune reconstitution 
      inflammatory syndrome?
PG  - 369-72
LID - 10.1177/0956462413506889 [doi]
AB  - Cryptococcosis, a significant opportunistic infection, has become a global 
      concern since the advent of immunosuppressive chemotherapy or in immunodeficient 
      patients. Host responses range from a harmless colonization to disseminated 
      disease. An accurate or definitive diagnosis in patients with cryptococcal 
      meningitis is often delayed because of the similar clinical presentation and 
      biochemical or cerebrospinal fluid findings to those of a variety of infectious 
      and non-infectious aetiologies, most of which are also especially prevalent in 
      developing countries. Rarely, patients with cryptococcal meningitis can develop 
      immune reconstitution inflammatory syndrome (IRIS) when initiated on combination 
      antiretroviral therapy (cART) the diagnosis which is often missed and can be 
      fatal. Due to the similar presentation of infection and IRIS, it is often 
      confused with the relapse of cryptococcal meningitis. We report a case of 
      paradoxical recurrent meningitis in response to the initiation of cART in a 
      patient diagnosed with cryptococcal meningitis and propose that the recurrent 
      symptoms resulted from a therapy-induced reconstitution of the immune response 
      against residual Cryptococcus neoformans.
FAU - Jhamb, Rajat
AU  - Jhamb R
AD  - Department of Medicine, University College of Medical Sciences (UCMS) and Guru 
      Teg Bahadur (GTB) Hospital, Delhi, India.
FAU - Kashyap, Bineeta
AU  - Kashyap B
FAU - Das, Shukla
AU  - Das S
FAU - Berry, Neha
AU  - Berry N
FAU - Garg, Arun
AU  - Garg A
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20131009
PL  - England
TA  - Int J STD AIDS
JT  - International journal of STD & AIDS
JID - 9007917
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Antifungal Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/diagnosis/drug therapy/immunology
MH  - Adult
MH  - Anti-HIV Agents/adverse effects/therapeutic use
MH  - Antifungal Agents/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Cryptococcus neoformans/*isolation & purification
MH  - HIV Infections/complications/*drug therapy/immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*chemically induced
MH  - Male
MH  - Meningitis, Cryptococcal/*diagnosis/drug therapy/immunology
MH  - Recurrence
MH  - Treatment Outcome
OTO - NOTNLM
OT  - AIDS
OT  - Cryptococcal meningitis
OT  - Cryptococcus neoformans
OT  - HIV
OT  - IRIS
OT  - antiretroviral therapy
OT  - diagnosis
OT  - immune reconstitution inflammatory syndrome
OT  - recurrent
EDAT- 2013/10/11 06:00
MHDA- 2014/05/13 06:00
CRDT- 2013/10/11 06:00
PHST- 2013/10/11 06:00 [entrez]
PHST- 2013/10/11 06:00 [pubmed]
PHST- 2014/05/13 06:00 [medline]
AID - 0956462413506889 [pii]
AID - 10.1177/0956462413506889 [doi]
PST - ppublish
SO  - Int J STD AIDS. 2014 Apr;25(5):369-72. doi: 10.1177/0956462413506889. Epub 2013 
      Oct 9.