PMID- 34912749
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220429
IS  - 2284-2594 (Electronic)
IS  - 2284-2594 (Linking)
VI  - 8
IP  - 11
DP  - 2021
TI  - Nannizziopsis Immune Reconstitution Inflammatory Syndrome in a Patient with HIV: 
      First Reported Case.
PG  - 003021
LID - 10.12890/2021_003021 [doi]
LID - 003021
AB  - We describe the case of a 35-year-old HIV-positive male of African origin 
      diagnosed with neurotoxoplasmosis and a Nannizziopsis spp. cavitating pulmonary 
      lesion unmasking immune reconstitution inflammatory syndrome (IRIS). The patient 
      presented with headache, left hemiparesis and confusion. MRI of the brain showed 
      two space-occupying lesions in the right basal ganglia and left parietal lobe 
      typical for neurotoxoplasmosis. The patient tested positive for HIV and had 
      advanced CD4 lymphopenia. After commencement of antiretroviral treatment, a CT 
      scan of the chest showed a cavitating lesion in the right upper lobe. The 
      diagnosis of Nannizziopsis spp. fungal infection was confirmed by DNA sequencing 
      on a bronchial wash sample. The patient achieved complete recovery with 
      antiretroviral therapy, standard neurotoxoplasmosis treatment and antifungal 
      treatment with voriconazole for 12 weeks. LEARNING POINTS: AIDS patients at risk 
      of multiple concomitant opportunistic infections present a significant diagnostic 
      challenge.Unusual pathologies should also be considered in addition to the most 
      common opportunistic pathogens, especially in the context of immune 
      reconstitution inflammatory syndrome.
CI  - (c) EFIM 2021.
FAU - Zhao, Yi
AU  - Zhao Y
AD  - Imperial College London School of Medicine, London, UK.
FAU - Nozdrin, Mikhail
AU  - Nozdrin M
AD  - Imperial College London School of Medicine, London, UK.
FAU - Dalla Pria, Alessia
AU  - Dalla Pria A
AD  - Department of Infectious Diseases, Imperial College London, London, UK.
AD  - Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK.
FAU - Bracchi, Margherita
AU  - Bracchi M
AD  - Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20211123
PL  - Italy
TA  - Eur J Case Rep Intern Med
JT  - European journal of case reports in internal medicine
JID - 101648453
PMC - PMC8668001
OTO - NOTNLM
OT  - HIV
OT  - IRIS
OT  - Nannizziopsis
OT  - immune reconstitution inflammatory syndrome
COIS- Conflicts of Interests: The authors declare there are no competing interests.
EDAT- 2021/12/17 06:00
MHDA- 2021/12/17 06:01
PMCR- 2021/11/23
CRDT- 2021/12/16 06:35
PHST- 2021/10/21 00:00 [received]
PHST- 2020/10/30 00:00 [accepted]
PHST- 2021/12/16 06:35 [entrez]
PHST- 2021/12/17 06:00 [pubmed]
PHST- 2021/12/17 06:01 [medline]
PHST- 2021/11/23 00:00 [pmc-release]
AID - 3021-1-25669-2-10-20211123 [pii]
AID - 10.12890/2021_003021 [doi]
PST - epublish
SO  - Eur J Case Rep Intern Med. 2021 Nov 23;8(11):003021. doi: 10.12890/2021_003021. 
      eCollection 2021.