| Immune reconstitution syndrome in a patient with disseminated histoplasmosis and steroid taper: maintaining the perfect balance. | |
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MedLine Citation:
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PMID: 19843232 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Immune reconstitution syndrome (IRS) is an increasingly common condition that has been described in immunosuppressed individuals once immune function is restored. In this case, we describe a patient who had a renal transplant and subsequently developed pulmonary histoplasmosis. His course was also complicated by the development of a clinical syndrome that was originally attributed to thrombocytopenic thrombotic purpura (TTP). When he did not improve with plasmapheresis and high dose prednisone, a bone marrow biopsy revealed disseminated histoplasmosis and administration of prednisone was rapidly tapered. While on 5 mg of prednisone, he developed an inflammatory syndrome characterised by haemoptysis and respiratory distress, full work-up with pathology was consistent with immune reconstitution syndrome. Treatment for IRS consists of continuing treatment for the underlying infection and consideration of administering anti-inflammatory medication for supportive care. This syndrome should be considered in patients who develop worsening inflammatory symptoms while receiving appropriate treatment for their fungal infection in the setting of restoration of immune function. |
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Authors:
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Alison Jazwinski; Susanna Naggie; John Perfect |
Publication Detail:
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Type: Letter |
Journal Detail:
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Title: Mycoses Volume: 54 ISSN: 1439-0507 ISO Abbreviation: Mycoses Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8805008 Medline TA: Mycoses Country: Germany |
Other Details:
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Languages: eng Pagination: 270-2 Citation Subset: IM |
Copyright Information:
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© 2009 Blackwell Verlag GmbH. |
Affiliation:
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Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA Department of Infectious Disease, Duke University Medical Center, Durham, NC, USA. |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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