Probable cerebral Mycobacterium avium complex-related immune reconstitution inflammatory syndrome in an HIV-infected patient.
The advent of highly active anti-retroviral therapy (HAART) has reduced both the morbidity and incidence of acquired immunodeficiency syndrome (AIDS)-related central nervous system (CNS) diseases. However, some patients seem to suffer paradoxical clinical deterioration after starting HAART, known as immune reconstitution inflammatory syndrome (IRIS). We report a rare case of probable Mycobacterium avium complex (MAC) infection of the brain in a patient with AIDS who had been treated effectively for probable pulmonary and cerebral MAC infection, with both lesions recurring after significant decreases in plasma human immunodeficiency virus type-1 viral load following initiation of HAART. This case appears to represent the first precise clinicopathological description of severe ventriculo-encephalitis in CNS MAC-related IRIS.
Kishida
Shuji
S
Division of Neurology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo. s-kisida@cick.jp
Ajisawa
Atsushi
A
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000473:pathology*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D020806:Central Nervous System Bacterial Infections / Q000175:diagnosis / Q000473:pathology*; D002552:Cerebral Ventricles / Q000382:microbiology / Q000473:pathology*; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000473:pathology*