Cryptococcal breast abscess in an HIV-positive patient: arguments for reviewing the definition of immune reconstitution inflammatory syndrome

J Infect. 2008 Jul;57(1):82-4. doi: 10.1016/j.jinf.2008.01.010. Epub 2008 Mar 4.

Abstract

Atypical manifestations of Cryptococcus neoformans disease have been reported in patients with HIV-1 infection as part of the spectrum of the immune reconstitution inflammatory syndrome (IRIS). We describe a cryptococcal breast abscess in a patient presenting after 11 months of highly active antiretroviral therapy (HAART). The arguments for and against the case being a novel manifestation of IRIS are discussed. The potential hazards of using CD4 count as a surrogate marker of IRIS and the danger of misdiagnosing IRIS as failure of HAART are highlighted.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / complications
  • AIDS-Related Opportunistic Infections / immunology
  • AIDS-Related Opportunistic Infections / microbiology
  • Abscess / microbiology*
  • Antiretroviral Therapy, Highly Active
  • Breast / microbiology*
  • Cryptococcosis / complications*
  • Cryptococcosis / immunology*
  • Cryptococcosis / microbiology
  • Cryptococcus neoformans / isolation & purification
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • HIV Infections / immunology*
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / immunology*
  • Middle Aged