PMID- 24910267
OWN - NLM
STAT- MEDLINE
DCOM- 20150615
LR  - 20211021
IS  - 1471-2334 (Electronic)
IS  - 1471-2334 (Linking)
VI  - 14
DP  - 2014 Jun 9
TI  - Cytomegalovirus immune reconstitution inflammatory syndrome manifesting as acute 
      appendicitis in an HIV-infected patient.
PG  - 313
LID - 10.1186/1471-2334-14-313 [doi]
AB  - BACKGROUND: Appendicitis occurs with increased frequency in HIV infected compared 
      to HIV uninfected persons. CMV-related appendicitis specifically presents with 
      typical appendicitis symptoms including surgical abdomen, fever and leukocytosis 
      and may have a more severe course with higher mortality than other types of 
      infective appendicitis. We report the first case of CMV appendicitis as a 
      manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS). CASE 
      PRESENTATION: The patient was a 38 year old woman with a recent diagnosis of HIV 
      infection who complained of right lower quadrant pain, anorexia, nausea and 
      fevers two weeks after initiating antiretroviral therapy. Acute appendicitis was 
      suspected and the patient underwent an appendectomy. Pathologic examination of 
      the resected appendiceal tissue demonstrated inflammation with perforation and 
      cytopathic changes typical of CMV that were positive for CMV by immunostain. This 
      presentation of CMV abruptly after antiretroviral therapy initiation with a 
      pronounced cellular infiltration of the tissue, is consistent with CMV-IRIS 
      presenting as appendicitis. CONCLUSIONS: Appendicitis can be a rare manifestation 
      of CMV-IRIS in HIV-infected patients who start antiretroviral therapy. Evaluation 
      of appendiceal tissue for cytopathic changes and CMV should be considered in 
      acute appendicitis in HIV infected persons.
FAU - Faldetta, Kimberly F
AU  - Faldetta KF
FAU - Kattakuzhy, Sarah
AU  - Kattakuzhy S
FAU - Wang, Hao-Wei
AU  - Wang HW
FAU - Sereti, Irini
AU  - Sereti I
FAU - Sheikh, Virginia
AU  - Sheikh V
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, USA. 
      sheikhv@niaid.nih.gov.
LA  - eng
GR  - HHSN261200800001E/PHS HHS/United States
GR  - Howard Hughes Medical Institute/United States
GR  - Intramural NIH HHS/United States
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20140609
PL  - England
TA  - BMC Infect Dis
JT  - BMC infectious diseases
JID - 100968551
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Anti-HIV Agents/*therapeutic use
MH  - Appendicitis/diagnosis/*etiology/virology
MH  - Cytomegalovirus Infections/diagnosis/*etiology
MH  - Drug Therapy, Combination
MH  - Female
MH  - HIV Infections/complications/*drug therapy
MH  - *HIV-1
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/complications/*diagnosis
PMC - PMC4057562
EDAT- 2014/06/10 06:00
MHDA- 2015/06/16 06:00
PMCR- 2014/06/09
CRDT- 2014/06/10 06:00
PHST- 2014/02/28 00:00 [received]
PHST- 2014/05/28 00:00 [accepted]
PHST- 2014/06/10 06:00 [entrez]
PHST- 2014/06/10 06:00 [pubmed]
PHST- 2015/06/16 06:00 [medline]
PHST- 2014/06/09 00:00 [pmc-release]
AID - 1471-2334-14-313 [pii]
AID - 10.1186/1471-2334-14-313 [doi]
PST - epublish
SO  - BMC Infect Dis. 2014 Jun 9;14:313. doi: 10.1186/1471-2334-14-313.