Symptomatic relapse of HIV-associated cryptococcal meningitis: recurrent cryptococcal meningitis or Cryptococcus-related immune reconstitution inflammatory syndrome?
Cryptococcosis, a significant opportunistic infection, has become a global concern since the advent of immunosuppressive chemotherapy or in immunodeficient patients. Host responses range from a harmless colonization to disseminated disease. An accurate or definitive diagnosis in patients with crypto...
| Publicado en: | International Journal of STD & AIDS Vol. 25; no. 5; pp. 369 - 373 |
|---|---|
| Autores principales: | , , , , |
| Formato: | case study Journal Article |
| Publicado: |
Sage Publications Inc.
Apr2014
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104052891&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104052891 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09564624 8O9 jtl: International Journal of STD & AIDS issn: 09564624 maglogo: Y pubinfo: dt: Apr2014 vid: 25 iid: 5 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 104052891 2012523074 10.1177/0956462413506889 NLM24108453 104052891 ppf: 369 ppct: 4 formats: tig: atl: Symptomatic relapse of HIV-associated cryptococcal meningitis: recurrent cryptococcal meningitis or Cryptococcus-related immune reconstitution inflammatory syndrome? aug: au: Jhamb, Rajat Kashyap, Bineeta Das, Shukla Berry, Neha Garg, Arun affil: Department of Medicine, University College of Medical Sciences (UCMS) and Guru Teg Bahadur (GTB) Hospital, Delhi, India. sug: subj: Antiretroviral Therapy, Highly Active Adverse Effects Cryptococcus Immune Reconstitution Inflammatory Syndrome Chemically Induced Meningitis, Cryptococcal Diagnosis AIDS-Related Opportunistic Infections Diagnosis AIDS-Related Opportunistic Infections Drug Therapy AIDS-Related Opportunistic Infections Immunology Adult Anti-HIV Agents Adverse Effects Anti-HIV Agents Therapeutic Use Antifungal Agents Therapeutic Use HIV Infections Complications HIV Infections Immunology Male Meningitis, Cryptococcal Drug Therapy Meningitis, Cryptococcal Immunology Recurrence Treatment Outcomes Adult: 19-44 years Male ab: Cryptococcosis, a significant opportunistic infection, has become a global concern since the advent of immunosuppressive chemotherapy or in immunodeficient patients. Host responses range from a harmless colonization to disseminated disease. An accurate or definitive diagnosis in patients with cryptococcal meningitis is often delayed because of the similar clinical presentation and biochemical or cerebrospinal fluid findings to those of a variety of infectious and non-infectious aetiologies, most of which are also especially prevalent in developing countries. Rarely, patients with cryptococcal meningitis can develop immune reconstitution inflammatory syndrome (IRIS) when initiated on combination antiretroviral therapy (cART) the diagnosis which is often missed and can be fatal. Due to the similar presentation of infection and IRIS, it is often confused with the relapse of cryptococcal meningitis. We report a case of paradoxical recurrent meningitis in response to the initiation of cART in a patient diagnosed with cryptococcal meningitis and propose that the recurrent symptoms resulted from a therapy-induced reconstitution of the immune response against residual Cryptococcus neoformans. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|