Double trouble: Concomitant unmasking and paradoxical immune reconstitution inflammatory syndrome in a patient with newly diagnosed HIV

Authors

Jennifer Makhoul, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, Washington, DC, NW 20037, United States.
Surabhi Uppal, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, Washington, DC, NW 20037, United States.
Marc Siegel, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, Washington, DC, NW 20037, United States.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

IDCases

Volume

28

DOI

10.1016/j.idcr.2022.e01482

Keywords

Cryptococcus; Human Immunodeficiency Virus; Mycobacterium avium complex; Paradoxical IRIS; Unmasking IRIS

Abstract

Immune reconstitution inflammatory syndrome (IRIS) is a complication encountered in patients with HIV due to immune function recovery following the initiation of antiretroviral therapy. IRIS can be divided into two forms: paradoxical (recurrence of clinical signs of a previously treated opportunistic infection) and unmasking (uncovering of a previously undiagnosed and asymptomatic infection). We present the rare case of a 48-year-old man diagnosed with AIDS after presenting with cryptococcal meningitis who, shortly after initiation of ART, developed both unmasking IRIS due to (MAC), and subsequently paradoxical IRIS to his prior cryptococcal meningitis infection. To our knowledge, cases in the medical literature describing "double IRIS" remain scarce.

APA Citation

Makhoul, Jennifer; Uppal, Surabhi; and Siegel, Marc, "Double trouble: Concomitant unmasking and paradoxical immune reconstitution inflammatory syndrome in a patient with newly diagnosed HIV" (2022). GW Authored Works. Paper 538.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/538

Department

Medicine