Cryptococcal breast abscess in an HIV-positive patient: arguments for reviewing the definition of immune reconstitution inflammatory syndrome.
Atypical manifestations of Cryptococcus neoformans disease have been reported in patients with HIV-1 infection as part of the spectrum of the immune reconstitution inflammatory syndrome (IRIS). We describe a cryptococcal breast abscess in a patient presenting after 11 months of highly active antiretroviral therapy (HAART). The arguments for and against the case being a novel manifestation of IRIS are discussed. The potential hazards of using CD4 count as a surrogate marker of IRIS and the danger of misdiagnosing IRIS as failure of HAART are highlighted.
Haddow
Lewis J
LJ
Department of Infectious Diseases, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella 4013, South Africa.
Sahid
Faieza
F
Moosa
Mahomed-Yunus S
MY
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000276:immunology / Q000382:microbiology; D000038:Abscess / Q000382:microbiology*; D023241:Antiretroviral Therapy, Highly Active; D001940:Breast / Q000382:microbiology*; D003453:Cryptococcosis / Q000150:complications* / Q000276:immunology* / Q000382:microbiology; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000276:immunology*; D008875:Middle Aged