scholarly journals Understanding Pathogenesis and Care Challenges of Immune Reconstitution Inflammatory Syndrome in Fungal Infections

2018 ◽  
Vol 4 (4) ◽  
pp. 139 ◽  
Author(s):  
Sarah Dellière ◽  
Romain Guery ◽  
Sophie Candon ◽  
Blandine Rammaert ◽  
Claire Aguilar ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Fungal Infections ◽  
Current Knowledge ◽  
Immunosuppressive Agents ◽  
Fungal Species ◽  
Invasive Fungal Infections ◽  
Solid Organ ◽  
Mortality And Morbidity ◽  
Inflammatory Syndrome

Immune deficiency of diverse etiology, including human immunodeficiency virus (HIV), antineoplastic agents, immunosuppressive agents used in solid organ recipients, immunomodulatory therapy, and other biologics, all promote invasive fungal infections. Subsequent voluntary or unintended immune recovery may induce an exaggerated inflammatory response defining immune reconstitution inflammatory syndrome (IRIS), which causes significant mortality and morbidity. Fungal-associated IRIS raises several diagnostic and management issues. Mostly studied with Cryptococcus, it has also been described with other major fungi implicated in human invasive fungal infections, such as Pneumocystis, Aspergillus, Candida, and Histoplasma. Furthermore, the understanding of IRIS pathogenesis remains in its infancy. This review summarizes current knowledge regarding the clinical characteristics of IRIS depending on fungal species and existing strategies to predict, prevent, and treat IRIS in this patient population, and tries to propose a common immunological background to fungal IRIS.

scholarly journals Impact of the immune reconstitution inflammatory syndrome (IRIS) on mortality and morbidity in HIV-infected patients in Mexico

2011 ◽  
Vol 15 (6) ◽  
pp. e408-e414 ◽  
Author(s):  
Irma Hoyo-Ulloa ◽  
Pablo F. Belaunzarán-Zamudio ◽  
Brenda Crabtree-Ramirez ◽  
Arturo Galindo-Fraga ◽  
María Eugenia Pérez-Aguinaga ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Mortality And Morbidity ◽  
Inflammatory Syndrome

scholarly journals Immune Reconstitution Inflammatory Syndrome Occurring in a Kidney Transplant Patient with Extrapulmonary Tuberculosis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Jose Iglesias ◽  
Kandria Jumil Ledesma ◽  
Paul J. Couto ◽  
Jessie Liu
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Extrapulmonary Tuberculosis ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
High Risk Group ◽  
Kidney Transplant Patient ◽  
Solid Organ ◽  
Inflammatory Syndrome

Tuberculosis (TB) occurring in solid organ transplantation (SOT) is associated with significant morbidity and mortality usually due to delays in diagnosis, drug toxicity encountered with antimycobacterial therapy, and drug-drug interactions. TB in SOT patients may mimic other infectious and noninfectious posttransplant complications such as posttransplant lymphoproliferative disorder (PTLD) and systemic cytomegalovirus infection. Immune reconstitution inflammatory syndrome (IRIS) is a host response resulting in paradoxical worsening of an infectious disease which occurs after the employment of effective therapy and reversal of an immunosuppressed state. We describe the development of immune reconstitution inflammatory syndrome (IRIS), a unique complication occurring during the treatment of extrapulmonary tuberculosis occurring after transplant which resulted from decreasing immunosuppression in a patient who received Alemtuzumab induction therapy. Although (IRIS) has been originally described in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART), solid organ transplant recipients with diagnosed or occult TB whose immune system may undergo immune reconstitution during their posttransplant course represent a new high risk group.

Disseminated coccidioidomycosis in a patient who is immunocompromised in the setting of immune reconstitution inflammatory syndrome

2021 ◽  
Vol 14 (4) ◽  
pp. e227217
Author(s):  
Hamid Yaqoob ◽  
Muhammad Mohsin Munawar ◽  
Omer Salih ◽  
Anand Deonarine
Keyword(s):  
Bone Marrow ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Airborne Spores ◽  
Systemic Fungal Infection ◽  
Art Initiation ◽  
Paradoxical Worsening ◽  
Inflammatory Syndrome

Coccidioidomycosis is a systemic fungal infection first described in 1892. More than 95% of annual cases occur in Arizona and California. It is an opportunistic infection (OI) transmitted via inhalation of airborne spores (arthroconidia) and rarely via percutaneous inoculation into a tissue or solid organ transplantation in patients who are immunocompromised and with HIV. With the advent of antiretroviral therapy (ART), the incidence of OIs has markedly reduced; however, OIs continue to occur, particularly in patients who present late for medical care or delay ART initiation. In rare cases, immunodeficient individuals may experience a paradoxical worsening or unmasking of OI symptoms, known as the immune reconstitution inflammatory syndrome (IRIS). We present a case of a 31-year-old man with disseminated coccidioidomycosis affecting the spleen, lymph nodes, lungs, bone marrow, and adrenals who developed IRIS after the initiation of ART.

scholarly journals “Chronic Disseminated Aspergillosis,” a Novel Fungal Immune Reconstitution Inflammatory Syndrome

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Annabelle Pourbaix ◽  
Romain Guery ◽  
Julie Bruneau ◽  
Estelle Blanc ◽  
Gregory Jouvion ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Clinical Presentation ◽  
Castleman Disease ◽  
Disease Symptoms ◽  
Disseminated Candidiasis ◽  
Multicentric Castleman Disease ◽  
Chronic Disseminated Candidiasis ◽  
Disseminated Aspergillosis ◽  
Inflammatory Syndrome

Abstract We report a case of chronic hepatosplenic aspergillosis following immune reconstitution complicating colic aspergillosis in an AIDS patient with multicentric Castleman disease. Symptoms mimicked the clinical presentation of chronic disseminated candidiasis and responded to corticosteroid. This emerging entity enlarges the spectrum of fungal immune reconstitution inflammatory syndrome in the HIV setting.

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