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Acute bilateral parotitis caused by Mycobacterium scrofulaceum: immune reconstitution disease in a patient with AIDS
  1. S D Lawn1,2,
  2. A Checkley1,
  3. M H Wansbrough-Jones1
  1. 1Department of Infectious Diseases, St George’s Hospital Medical School, London SW17 0RE, UK
  2. 2Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to:
 Stephen D Lawn
 Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town. South Africa; stevelawn{at}yahoo.co.uk

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Immune reconstitution disease (IRD) among HIV infected patients is an adverse consequence of restoration of immune responses during the initial months of antiretroviral treatment (ART).1 Previously, subclinical infections are “unmasked” or pre-existing opportunistic infections clinically deteriorate. Here we describe an unusual case in which a patient developed acute bilateral parotid enlargement as a result of IRD associated with Mycobacterium scrofulaceum infection.

A 66 year old West African man was investigated for dysphagia, weight loss, and fatigue. Oesophageal candidiasis and HIV-1 infection were diagnosed with a blood CD4 lymphocyte count of 6 cells ×106/l and a plasma viral load of 416 566 RNA copies/ml. Further investigations, including chest radiography, sputum examination, mycobacterial blood cultures, bone marrow examination and …

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