Introduction: Soon after the introduction of antiretroviral therapy for HIV infection, some patients may develop an inflammatory immune reconstitution syndrome, in the presence of clinically unsuspected infection.
Case report: We describe a 31 year old patient, who presented with a lymphoid interstitial pneumonia associated with HIV infection. Unexpectedly, 15 days after the beginning of antiretroviral therapy, he developed a worsening of his respiratory function due to Pneumocystis infection.
Conclusion: The appearance or aggravation of pulmonary symptoms, after highly active antiretroviral therapy has been initiated should lead to suspicion of an opportunist infection. Specific sampling must be considered.