title: Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature.
abstract: We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.
authors: Laboratório de Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors: Marcelo Rosandiski
authors: MR
authors: Lyra
authors: Departamento de Doenças Infecciosas, Hospital Central do Exército, Rio de Janeiro, RJ, Brasil.
authors: Maria Letícia Fernandes Oliveira
authors: ML
authors: Nascimento
authors: Laboratório de Micobactéria, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors: Andréa Gina
authors: AG
authors: Varon
authors: Laboratório de Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors: Maria Inês Fernandes
authors: MI
authors: Pimentel
authors: Laboratório de Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors: Liliane de Fátima
authors: Lde F
authors: Antonio
authors: Laboratório de Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors: Maurício Naoto
authors: MN
authors: Saheki
authors: Laboratório de Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors: Sandro Javier
authors: SJ
authors: Bedoya-Pacheco
authors: Laboratório de Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors: Antonio Carlos Francesconi do
authors: AC
authors: Valle
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications* / Q000276:immunology; D008297:Male; D013174:Sporotrichosis / Q000209:etiology* / Q000276:immunology; D019562:Viral Load; D055815:Young Adult