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Progressive symptoms and signs following institution of highly active antiretroviral therapy and subsequent antituberculosis therapy: immune reconstitution syndrome or infection?
Abstract
A 36 year old man presented with weight loss, cough, fever, and exertional dyspnoea shortly after a diagnosis of HIV infection. Symptoms and initial radiological abnormalities worsened after highly active antiretroviral therapy was started. An eventual diagnosis was established but multiple problems occurred throughout the treatment period. Differentiation between immune reconstitution inflammatory syndrome and an infective cause was problematic.
- AAFB, alcohol and acid fast bacilli
- BAL, bronchoscopic alveolar lavage
- BM, bone marrow
- CRP, C reactive protein
- HAART, highly active antiretroviral therapy
- Hb, haemoglobin
- IRIS, immune reconstitution inflammatory syndrome
- LDH, lactate dehydrogenase
- MDR-TB, multidrug resistant tuberculosis
- PCP, Pneumocystis jirovecii pneumonia
- WBC, white blood cell
- HAART
- HIV
- AIDS
- tuberculosis
- immune reconstitution inflammatory syndrome
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