title: Immune reconstitution syndrome after successful treatment of Pneumocystis carinii pneumonia in a man with human immunodeficiency virus type 1 infection.
abstract: We describe a 34-year-old man with human immunodeficiency virus infection who received successful treatment of minimally symptomatic Pneumocystis carinii pneumonia and who subsequently developed diffuse pulmonary infiltrates and hypoxia 2 weeks after initiation of combination antiretroviral therapy. Initial pathologic evaluation of lung-tissue samples revealed no organisms, but a polymerase chain reaction assay was strongly positive for P. carinii DNA. We hypothesize that this patient's clinical presentation denotes immune reconstitution syndrome in response to residual P. carinii antigen in the lung.
authors.affiliation: Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. christine_koval@urmc.rochester.edu
authors.forename: Christine E
authors.initials: CE
authors.lastname: Koval
authors.forename: Francis
authors.initials: F
authors.lastname: Gigliotti
authors.forename: Diana
authors.initials: D
authors.lastname: Nevins
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Demeter
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D000328:Adult; D000946:Antigens, Fungal / Q000276:immunology; D004271:DNA, Fungal / Q000032:analysis; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D008297:Male; D011010:Pneumocystis / Q000235:genetics / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D000946:Antigens, Fungal; D004271:DNA, Fungal