| Fatal immune reconstitution inflammatory syndrome with human immunodeficiency virus infection and Candida meningitis: case report and review of the literature. | |
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MedLine Citation:
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PMID: 18569461 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Immune reconstitution inflammatory syndrome (IRIS) is an increasingly recognized phenomenon of paradoxical worsening of patients with acquired immunodeficiency syndrome (AIDS) upon initiation of highly active antiretroviral therapy (HAART). To date, there have been limited reports of IRIS in the central nervous system (CNS). Here, the authors describe a 43-year-old man with AIDS who presented with subacute meningitis. No pathogenic organism was identified by routine diagnostic tests, and he was treated empirically with an antituberculous regimen and initiated on HAART therapy. Soon after, he had a precipitous neurologic decline leading to his death. Postmortem evaluation showed a basilar Candida meningitis as well as vasculitis characterized by CD8+ T-cell infiltration, consistent with IRIS. The authors discuss the challenges in diagnosing fungal meningitides and the risks of initiating HAART therapy in those with possible undiagnosed underlying opportunistic infections. Additionally, the authors review the literature regarding CNS IRIS. |
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Authors:
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Jennifer L Berkeley; Avindra Nath; Carlos A Pardo |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of neurovirology Volume: 14 ISSN: 1538-2443 ISO Abbreviation: J. Neurovirol. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-06-23 Completed Date: 2008-09-03 Revised Date: 2011-06-02 |
Medline Journal Info:
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Nlm Unique ID: 9508123 Medline TA: J Neurovirol Country: United States |
Other Details:
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Languages: eng Pagination: 267-76 Citation Subset: IM |
Affiliation:
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Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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AIDS-Related Opportunistic Infections
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etiology*,
pathology Acquired Immunodeficiency Syndrome / complications* Adult Antiretroviral Therapy, Highly Active Antiviral Agents / therapeutic use* Brain Stem / microbiology, pathology CD8-Positive T-Lymphocytes / cytology Candida / isolation & purification* Candidiasis / complications*, diagnosis* Cell Proliferation Diagnosis Fatal Outcome HIV-1* Humans Immune Reconstitution Inflammatory Syndrome / etiology*, pathology Male Meningitis, Fungal / diagnosis* Review Literature as Topic Vasculitis / pathology |
| Grant Support | |
ID/Acronym/Agency:
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K08 DA016160-04/DA/NIDA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antiviral Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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