title: Histoplasmosis-associated immune reconstitution inflammatory syndrome.
abstract: A 27-year-old HIV-positive male patient with disseminated cutaneous histoplasmosis was treated with both HAART and amphotericin B (total accumulated dose of 0.5 g). Amphotericin B was later replaced with itraconazole (200mg/day). Two months after therapy had been started and the cutaneous lesions had healed, the patient interrupted both treatments voluntarily and his health deteriorated. HAART was then re-introduced and CD4+ cell count increased sharply at the same time as lymph node histoplasmosis was diagnosed. This paradoxical response? the relapse of histoplasmosis and concomitant increase in CD4+ cell count and undetectable viral load after resumption of HAART ? suggests that this was a case of immune reconstitution inflammatory syndrome (IRIS).
authors: Fundação de Hematologia e Hemoterapia do Amazonas, Manaus, AM, Brasil.
authors: Leny
authors: L
authors: Passos
authors: Carolina
authors: C
authors: Talhari
authors: Monica
authors: M
authors: Santos
authors: Rodrigo
authors: R
authors: Ribeiro-Rodrigues
authors: Luiz Carlos de Lima
authors: LC
authors: Ferreira
authors: Sinesio
authors: S
authors: Talhari
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000276:immunology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D006660:Histoplasmosis / Q000150:complications* / Q000276:immunology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications* / Q000276:immunology; D008297:Male; D055118:Medication Adherence; D019562:Viral Load