PMID- 29159660
OWN - NLM
STAT- MEDLINE
DCOM- 20190905
LR  - 20190906
IS  - 1573-0832 (Electronic)
IS  - 0301-486X (Linking)
VI  - 183
IP  - 3
DP  - 2018 Jun
TI  - Opinion: Paracoccidioidomycosis and HIV Immune Recovery Inflammatory Syndrome.
PG  - 495-498
LID - 10.1007/s11046-017-0230-9 [doi]
AB  - Two distinct patterns of immune recovery inflammatory syndrome (IRIS) are 
      recognized, paradoxical and unmasking IRIS. Here we raise some concerns regarding 
      the first case of neuroPCM-IRIS published to date, as recently proposed by 
      Almeida and Roza (Mycopathologia 177:137-141, 2017) for a patient originally 
      described by Silva-Vergara et al. (Mycopathologia 182:393-396, 2014), taking in 
      account the different case definitions for IRIS and the cases of 
      neuroparacoccidioidomycosis already described in the literature. We are concerned 
      that data from the case report have been misinterpreted and that no regard has 
      been given to the possibility that the development of manifestations of neuroPCM 
      after starting antiretroviral therapy and antifungal treatments could represent 
      the predicted course of a missed neuroPCM diagnosis at presentation whose 
      treatment failed. We hypothesize that diagnosis of the neuroPCM would not have 
      been missed if careful screening for opportunistic infection of the central 
      nervous system was performed prior to antiretroviral therapy initiation. 
      Currently, there is no definitive diagnostic test for IRIS and diagnostic 
      suspicion, as well as its management, are based on image studies and non-specific 
      clinical signs and symptoms of inflammation. IRIS remains a diagnosis of 
      exclusion, after considering drug toxicity, microbiologic treatment failure and 
      the expected course of newly or previously diagnosed opportunistic infections.
FAU - Buccheri, Renata
AU  - Buccheri R
AUID- ORCID: 0000-0002-3217-5898
AD  - Instituto de Infectologia Emilio Ribas, Sao Paulo, Brazil. 
      renatabuccheri@gmail.com.
AD  - Laboratory of Medical Investigation Unit #53, Medical School and Tropical 
      Medicine Institute, University of Sao Paulo Medical School, Avenida Doutor 
      Arnaldo, 455. Cerqueira Cesar, Sao Paulo, SP, Brazil. renatabuccheri@gmail.com.
FAU - Benard, Gil
AU  - Benard G
AD  - Laboratories of Medical Investigation Units #53 and #56, Medical School and 
      Tropical Medicine Institute, University of Sao Paulo Medical School, Avenida 
      Doutor Arnaldo 455, Sao Paulo, SP, Brazil.
LA  - eng
PT  - Case Reports
PT  - Comment
PT  - Journal Article
DEP - 20171120
PL  - Netherlands
TA  - Mycopathologia
JT  - Mycopathologia
JID - 7505689
SB  - IM
CON - Mycopathologia. 2014 Feb;177(1-2):137-41. PMID: 24464241
MH  - *Acquired Immunodeficiency Syndrome
MH  - HIV
MH  - *HIV Infections
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome
MH  - Nervous System
MH  - *Paracoccidioidomycosis
OTO - NOTNLM
OT  - HIV
OT  - Paracoccidioidomycosis
OT  - Paradoxical IRIS
OT  - Unmasking IRIS
EDAT- 2017/11/22 06:00
MHDA- 2019/09/07 06:00
CRDT- 2017/11/22 06:00
PHST- 2017/09/25 00:00 [received]
PHST- 2017/11/16 00:00 [accepted]
PHST- 2017/11/22 06:00 [pubmed]
PHST- 2019/09/07 06:00 [medline]
PHST- 2017/11/22 06:00 [entrez]
AID - 10.1007/s11046-017-0230-9 [pii]
AID - 10.1007/s11046-017-0230-9 [doi]
PST - ppublish
SO  - Mycopathologia. 2018 Jun;183(3):495-498. doi: 10.1007/s11046-017-0230-9. Epub 
      2017 Nov 20.