Brain tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-positive patient: a biopsy-proven case

Authors

  • Maria Letizia Giancola National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Francesco Baldini National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Carmine Maria Carapella Department Neuroscience, Regina Elena National Cancer Institute, Rome, Italy
  • Elisa Busi Rizzi National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy
  • Rita Maddaluno National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Lucia Alba National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Andrea Antinori National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy

DOI:

https://doi.org/10.3855/jidc.5552

Keywords:

HIV, tuberculosis, tuberculoma, immune reconstitution inflammatory syndrome (IRIS), antiretroviral therapy, central nervous system

Abstract

The case of an HIV-infected man from Eritrea previously diagnosed with tuberculosis, who presented neurological impairment and cerebral lesion after having voluntarily stopped anti-tubercular and antiretroviral therapies, is here reported. Treatments associated with steroids and mannitol were administered. The patient’s condition improved, but neuroimaging showed a continuous worsening of the lesion, while a great immunological reconstitution was observed. Brain microsurgery was performed. A tuberculosis diagnosis was supported by pathological and microbiological examinations. Tuberculosis arising during immune reconstitution inflammatory syndrome is a complication of antiretroviral treatment and is considered to be an emerging disorder, especially in countries highly endemic for tuberculosis.

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Published

2015-05-18

How to Cite

1.
Giancola ML, Baldini F, Carapella CM, Busi Rizzi E, Maddaluno R, Alba L, Antinori A (2015) Brain tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-positive patient: a biopsy-proven case. J Infect Dev Ctries 9:536–540. doi: 10.3855/jidc.5552

Issue

Section

Case Reports