PMID- 33846175
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20230413
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 14
IP  - 4
DP  - 2021 Apr 12
TI  - Disseminated coccidioidomycosis in a patient who is immunocompromised in the 
      setting of immune reconstitution inflammatory syndrome.
LID - 10.1136/bcr-2018-227217 [doi]
LID - e227217
AB  - Coccidioidomycosis is a systemic fungal infection first described in 1892. More 
      than 95% of annual cases occur in Arizona and California. It is an opportunistic 
      infection (OI) transmitted via inhalation of airborne spores (arthroconidia) and 
      rarely via percutaneous inoculation into a tissue or solid organ transplantation 
      in patients who are immunocompromised and with HIV. With the advent of 
      antiretroviral therapy (ART), the incidence of OIs has markedly reduced; however, 
      OIs continue to occur, particularly in patients who present late for medical care 
      or delay ART initiation. In rare cases, immunodeficient individuals may 
      experience a paradoxical worsening or unmasking of OI symptoms, known as the 
      immune reconstitution inflammatory syndrome (IRIS). We present a case of a 
      31-year-old man with disseminated coccidioidomycosis affecting the spleen, lymph 
      nodes, lungs, bone marrow, and adrenals who developed IRIS after the initiation 
      of ART.
CI  - (c) BMJ Publishing Group Limited 2021. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Yaqoob, Hamid
AU  - Yaqoob H
AD  - Internal Medicine, Howard University Hospital, Washington, DC, USA.
FAU - Munawar, Muhammad Mohsin
AU  - Munawar MM
AD  - Internal Medicine, Howard University Hospital, Washington, DC, USA.
FAU - Salih, Omer
AU  - Salih O
AD  - Internal Medicine, Howard University Hospital, Washington, DC, USA.
FAU - Deonarine, Anand
AU  - Deonarine A
AD  - Internal Medicine, Howard University Hospital, Washington, DC, USA 
      a_deonarine@howard.edu.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210412
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
SB  - IM
MH  - *AIDS-Related Opportunistic Infections
MH  - Adult
MH  - *Coccidioidomycosis/drug therapy
MH  - *HIV Infections
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome
MH  - Immunocompromised Host
MH  - Male
PMC - PMC8047998
OTO - NOTNLM
OT  - HIV / AIDS
OT  - immunology
OT  - infections
COIS- Competing interests: None declared.
EDAT- 2021/04/14 06:00
MHDA- 2021/05/15 06:00
PMCR- 2023/04/12
CRDT- 2021/04/13 05:49
PHST- 2021/04/13 05:49 [entrez]
PHST- 2021/04/14 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2023/04/12 00:00 [pmc-release]
AID - 14/4/e227217 [pii]
AID - bcr-2018-227217 [pii]
AID - 10.1136/bcr-2018-227217 [doi]
PST - epublish
SO  - BMJ Case Rep. 2021 Apr 12;14(4):e227217. doi: 10.1136/bcr-2018-227217.