scholarly journals Disseminated Mycobacterium simiae and Mycobacterium avium infection causing an immune reconstitution inflammatory syndrome in a female patient with HIV infection

2021 ◽  
Vol 14 (5) ◽  
pp. e241037
Author(s):  
Jacqueline Alexandra Bachofner ◽  
Kristian Ikenberg ◽  
Bettina Schulthess ◽  
Johannes Nemeth
Keyword(s):  
Hiv Infection ◽  
Mycobacterium Avium ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Avium Infection ◽  
Inflammatory Syndrome ◽  
Mycobacterium Simiae ◽  
Mycobacterium Avium Infection ◽  
Standard Treatment Regimen

This case study discusses the management of a disseminated Mycobacterium simiae and Mycobacterium avium infection causing an immune reconstitution inflammatory syndrome in a 52-year-old woman with HIV infection. Disseminated M. avium infections have extensively been described in HIV patients; however, reports of infections with M. simiae are rare. Treatment of M. simiae infections is challenging due to its high rates of natural drug resistances, and thus far, no standard treatment regimen exists.

Immune reconstitution inflammatory syndrome associated with secondary syphilis: dermatologic, neurologic and ophthalmologic compromise in an HIV patient

2019 ◽  
Vol 30 (5) ◽  
pp. 509-511
Author(s):  
Sami Alcedo ◽  
Renee Newby ◽  
Juan José Montenegro ◽  
Paola Rondan ◽  
Jorge Arevalo ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Secondary Syphilis ◽  
Immune Reconstitution Syndrome ◽  
Clinical Expression ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

The presentation of syphilis as a manifestation of immune reconstitution inflammatory syndrome in patients with human immunodeficiency virus (HIV) infection is rare and can be associated with the varied clinical expression of unusual syphilitic manifestations. We report a case of immune reconstitution syndrome with dermatologic, ophthalmologic and neurologic compromise of secondary syphilis in a patient with HIV infection.

scholarly journals Clinical and immunologic predictors of Mycobacterium avium complex immune reconstitution inflammatory syndrome in a contemporary cohort of patients with HIV

2020 ◽  
Author(s):  
Kimberly F Breglio ◽  
Caian L Vinhaes ◽  
María B Arriaga ◽  
Martha Nason ◽  
Gregg Roby ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
T Cell Activation ◽  
Mycobacterium Avium ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Mycobacterium Avium Complex ◽  
Subsequent Development ◽  
Art Initiation ◽  
Increased Risk ◽  
Inflammatory Syndrome

Abstract Background Patients with HIV (PWH) can present with new or worsening symptoms associated with Mycobacterium avium complex (MAC) infection shortly after antiretroviral therapy (ART) initiation as MAC immune reconstitution inflammatory syndrome (MAC-IRIS). In this study, we assessed the utility of several laboratory tests as predictors of MAC-IRIS. Methods PWH with clinical and histologic and/or microbiologic evidence of MAC-IRIS were identified and followed up to 96 weeks post-ART initiation within a prospective study of 206 ART-naïve patients with CD4 <100 cells/µL. Results Fifteen (7.3%) patients presented with MAC-IRIS within a median interval of 26 days after ART initiation. Patients who developed MAC-IRIS had lower BMI, lower hemoglobin levels, a higher alkaline phosphatase and increased CD38 frequency and MFI on CD8 + T-cells, at the time of ART initiation compared to non-MAC IRIS patients. A decision tree inference model revealed that stratifying patients based on levels of alkaline phosphatase and D-dimer could predict the likelihood of MAC-IRIS. A binary logistic regression demonstrated that higher levels of alkaline phosphatase at baseline were associated with increased risk of MAC-IRIS development. Conclusions High alkaline phosphatase levels and increased CD8 + T-cell activation with low CD4 counts at ART initiation should warrant suspicion for subsequent development of MAC-IRIS.

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