scholarly journals Strongyloidosis Hyperinfection Syndrome in an HIV-Infected Patient: A Rare Manifestation of Immune Reconstitution Inflammatory Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Kartik Natrajan ◽  
Mahenderkumar Medisetty ◽  
Raviraj Gawali ◽  
Ajit Tambolkar ◽  
Divya Patel ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Immunocompromised Host ◽  
Strongyloides Stercoralis ◽  
Parasitic Infections ◽  
Infected Female ◽  
Resource Limited ◽  
Hyperinfection Syndrome ◽  
Advanced Hiv Disease ◽  
Inflammatory Syndrome

Parasitic infections such as Strongyloides stercoralis and HIV have been reported to coexist, particularly in resource-limited settings such as India. In an immunocompromised host, S. stercoralis can progress to strongyloidiasis hyperinfection syndrome (SHS). However, SHS is not common in patients with advanced HIV disease. Immune reconstitution inflammatory syndrome (IRIS) developing after initiation of antiretroviral therapy (ART) can target multiple pathogens including S. stercoralis. The authors present here a 46-year-old HIV-infected female who was recently diagnosed with HIV-1 infection, started ART, and developed SHS. Her upper GI endoscopy revealed severe gastroduodenitis, and X-ray chest showed extensive bilateral pneumonitis. We could identify S. stercoralis in induced sputum and duodenal biopsy. We could also identify gut inflammation to restrict invading parasites. After receiving antihelminthic therapy, she showed improvement, a course of events that fit the diagnosis of unmasking S. stercoralis IRIS.

scholarly journals A Rare Case of Cryptococcus gattii Meningitis in Advanced HIV Disease, Sagittal Thrombosis, and Immune Reconstitution Syndrome, Resolved With Isavuconazonium

2020 ◽  
Vol 8 ◽  
pp. 232470962095988
Author(s):  
Jerome Okudo ◽  
Valerie F. Civelli ◽  
Vishal K. Narang ◽  
Royce H. Johnson ◽  
Nadir Khan ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Hiv Disease ◽  
Sagittal Sinus ◽  
Advanced Hiv Disease ◽  
Inflammatory Syndrome ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

Cryptococcus gattii is a species that has received more recognition in the recent past as distinct from Cryptococcus neoformans. C gattii is known to cause meningeal disease in both immunocompetent and immunosuppressed hosts. Patients may be clinically asymptomatic until immunosuppressive conditions occur such as corticosteroid treatment or an HIV infection. HIV-associated cryptococcal infections are most often due to C neoformans. C gattii is found in a minority. Speciation and subtyping of Cryptococcus are not always accomplished. In many parts of the world, there is no availability for speciation of Cryptococcus. Travel history may provide a clue to the most probable species. This case demonstrates a case of C gattii meningitis with a multiplicity of complications. These include advanced HIV disease secondary to nonadherence, immune reconstitution inflammatory syndrome, and superior sagittal sinus thrombosis. The patient represented diagnostic and therapeutic dilemmas over time. Headache was the primary symptom in cryptococcal meningitis, immune reconstitution inflammatory syndrome, and superior sagittal sinus thrombosis. All are discussed in detail as potential etiologies for the primary disease. Isavuconazonium is a relatively new broad-spectrum antifungal azole that was used as salvage therapy.

scholarly journals Immune reconstitution inflammatory syndrome among adolescents: A report of cases in a resource-limited setting (Uganda)

2010 ◽  
Vol 11 (2) ◽  
Author(s):  
Christine Katusiime ◽  
Ponsiano Ocama ◽  
Andrew Kambugu
Keyword(s):  
Young Adults ◽  
Infectious Diseases ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Resource Limited Setting ◽  
Resource Limited ◽  
Inflammatory Syndrome ◽  
Limited Setting

We report immune reconstitution inflammatory syndromes in a cohort of adolescents/young adults over a period of 1 year at the Infectious Diseases Institute, Kampala, Uganda.

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