Multifocal tuberculosis-associated immune reconstitution inflammatory syndrome - a case report of a complicated scenario

Gopalan Narendran; Deivide Oliveira-de-Souza; Caian L Vinhaes; Kevan Akrami; Kiyoshi F Fukutani; Kesavamurthy Banu; Padmapriyadarsini Chandrasekaran; Narayanan Ravichandran; Irini Sereti; Soumya Swaminathan; Bruno B Andrade

doi:10.1186/s12879-019-4182-1

Multifocal tuberculosis-associated immune reconstitution inflammatory syndrome - a case report of a complicated scenario

BMC Infect Dis. 2019 Jun 17;19(1):529. doi: 10.1186/s12879-019-4182-1.

Authors

Gopalan Narendran¹, Deivide Oliveira-de-Souza^{2

3

4}, Caian L Vinhaes^{2

3

4}, Kevan Akrami^{2

5}, Kiyoshi F Fukutani^{2

3

4}, Kesavamurthy Banu⁶, Padmapriyadarsini Chandrasekaran¹, Narayanan Ravichandran⁷, Irini Sereti⁸, Soumya Swaminathan¹, Bruno B Andrade^{9

10

11

12

13

14

15}

Affiliations

¹ National Institute for Research in Tuberculosis, Chennai, 600031, India.
² Instituto GonçaloMoniz, Fundação Oswaldo Cruz, Salvador, 40296-710, Brazil.
³ Multinational Organization Network SponsoringTranslationaland Epidemiological Research (MONSTER) Initiative, Fundação José Silveira, Salvador, 40210-320, Brazil.
⁴ Curso de Medicina, Faculdade de Tecnologia e Ciências (FTC), Salvador, 40290-150, Brazil.
⁵ Division of Infectious Diseases, Department of Medicine, University of California, San Diego, USA.
⁶ Institute of Neurology, Madras Medical College, Chennai, India.
⁷ Government Hospital of Thoracic Medicine, Tambaram, Chennai, India.
⁸ National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
⁹ Instituto GonçaloMoniz, Fundação Oswaldo Cruz, Salvador, 40296-710, Brazil. [email protected].
¹⁰ Multinational Organization Network SponsoringTranslationaland Epidemiological Research (MONSTER) Initiative, Fundação José Silveira, Salvador, 40210-320, Brazil. [email protected].
¹¹ Curso de Medicina, Faculdade de Tecnologia e Ciências (FTC), Salvador, 40290-150, Brazil. [email protected].
¹² Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 7925, South Africa. [email protected].
¹³ Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA. [email protected].
¹⁴ Universidade Salvador (UNIFACS), Laureate Universities, Salvador, 41720-200, Brazil. [email protected].
¹⁵ Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, 40290-000, Brazil. [email protected].

Abstract

Background: Tuberculosis (TB)-associated Immune reconstitution inflammatory syndrome (TB-IRIS) is an aberrant inflammatory response in TB patients with advanced human immunodeficiency virus coinfection, after antiretroviral therapy commencement.

Case presentation: We present a rare case of a 51-year-old woman living with HIV who developed a series of TB-IRIS events occurring at multiple sites sequentially, highlighting the clinical complexity in diagnosis and management.

Conclusion: This case illustrates how complicated a clinical scenario of successive TB-IRIS episodes can be, in terms of clinical management.

Keywords: HIV; IRIS; Immune reconstitution inflammatory syndrome; Tuberculosis.

Publication types

Case Reports

MeSH terms

Anti-HIV Agents / adverse effects
Coinfection / drug therapy
Female
HIV Infections / complications*
HIV Infections / drug therapy
Humans
Immune Reconstitution Inflammatory Syndrome / diagnosis
Immune Reconstitution Inflammatory Syndrome / drug therapy
Immune Reconstitution Inflammatory Syndrome / etiology*
Middle Aged
Tuberculosis, Pulmonary / complications*

Substances

Anti-HIV Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding