PMID- 30937284
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231006
IS  - 2214-2509 (Print)
IS  - 2214-2509 (Electronic)
IS  - 2214-2509 (Linking)
VI  - 15
DP  - 2019
TI  - Tuberculosis-immune reconstitution inflammatory syndrome in HIV-infected patient: 
      A case report.
PG  - e00519
LID - 10.1016/j.idcr.2019.e00519 [doi]
LID - e00519
AB  - We describe a case of immune reconstitution inflammatory syndrome (IRIS) 
      secondary to reactivation of Mycobacterium tuberculosis in an HIV-infected 
      patient with a high CD4+ cell count, who presented with a generalized seizure 6 
      weeks after starting antiretroviral therapy (ART). In our patient, the 
      inflammatory response resulted in radiological features of neurological, 
      pulmonary, and lymph node (LN) tuberculosis- (TB) IRIS, without the typical 
      symptoms. Diagnosis was confirmed by LN biopsy and acid-fast bacilli (AFB) 
      culture of LN and sputum. Treatment with isoniazid, rifabutin, ethambutol, and 
      pyrazinamide was started in addition to continuation of ART. To our knowledge, we 
      describe the first case of an atypical clinical presentation of an unmasking 
      reaction of disseminated TB-IRIS in an HIV infected patient without acquired 
      immune deficiency syndrome (AIDS), with restoring immunity during ART. Clinical 
      and radiological predictors of TB-IRIS in co-infected patients starting ART are 
      therefore essential in anticipating complications and facilitating expeditious 
      management and prompt therapy.
FAU - Shuker, Orel
AU  - Shuker O
AD  - Division of Infectious Diseases, Department of Medicine, Maimonides Medical 
      Center, New York, United States.
FAU - Villamil, Jose
AU  - Villamil J
AD  - Division of Infectious Diseases, Department of Medicine, Maimonides Medical 
      Center, New York, United States.
FAU - Ghitan, Monica
AU  - Ghitan M
AD  - Division of Infectious Diseases, Department of Medicine, Maimonides Medical 
      Center, New York, United States.
FAU - Chapnick, Edward K
AU  - Chapnick EK
AD  - Division of Infectious Diseases, Department of Medicine, Maimonides Medical 
      Center, New York, United States.
FAU - Lin, Yu Shia
AU  - Lin YS
AD  - Division of Infectious Diseases, Department of Medicine, Maimonides Medical 
      Center, New York, United States.
LA  - eng
PT  - Case Reports
DEP - 20190312
PL  - Netherlands
TA  - IDCases
JT  - IDCases
JID - 101634540
PMC - PMC6430003
OTO - NOTNLM
OT  - Antiretroviral therapy
OT  - HIV
OT  - Immune reconstitution inflammatory syndrome
OT  - Tuberculosis
OT  - Unmasking
EDAT- 2019/04/03 06:00
MHDA- 2019/04/03 06:01
PMCR- 2019/03/12
CRDT- 2019/04/03 06:00
PHST- 2018/11/30 00:00 [received]
PHST- 2019/01/13 00:00 [revised]
PHST- 2019/03/06 00:00 [accepted]
PHST- 2019/04/03 06:00 [entrez]
PHST- 2019/04/03 06:00 [pubmed]
PHST- 2019/04/03 06:01 [medline]
PHST- 2019/03/12 00:00 [pmc-release]
AID - S2214-2509(18)30218-X [pii]
AID - e00519 [pii]
AID - 10.1016/j.idcr.2019.e00519 [doi]
PST - epublish
SO  - IDCases. 2019 Mar 12;15:e00519. doi: 10.1016/j.idcr.2019.e00519. eCollection 
      2019.