Paradoxical worsening of chest radiographs secondary to immune reconstitution syndrome (IRIS) in a patient with advanced HIV infection and Rhodococcus pneumonia

Koh KC; Ibrahim NM; Ong SCL

Paradoxical worsening of chest radiographs secondary to immune reconstitution syndrome (IRIS) in a patient with advanced HIV infection and Rhodococcus pneumonia

Koh KC ¹ , Ibrahim NM ² , Ong SCL ³

Affiliations

¹ International Medical University, Department of Internal Medicine, Seremban, Negeri Sembilan, Malaysia. [email protected]
² Hospital Sultanah Nur Zahirah, Department of Medicine, Kuala Terengganu, Terengganu, Malaysia
³ International Medical University, Department of Internal Medicine, Seremban, Negeri Sembilan, Malaysia

Med J Malaysia, 2020 03;75(2):164-166.

PMID: 32281599

Abstract

We present a rare case of post-antiretroviral therapy (ART) paradoxically worsening of radiological findings in a patient with advanced HIV-infection on treatment for Rhodococcus pneumonia who was misdiagnosed with pulmonary tuberculosis. Despite clinical improvement, serial chest radiographs showed deteriorations a month after starting ART. This was attributed to Immune Reconstitution Inflammatory Syndrome (IRIS) which spontaneously resolved without any treatment.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.