title: Thoracic manifestations of paradoxical immune reconstitution inflammatory syndrome during or after antituberculous therapy in HIV-negative patients.
abstract: Immune reconstitution inflammatory syndrome (IRIS) is a consequence of exaggerated and dysregulated host's inflammatory response to invading microorganism, leading to uncontrolled inflammatory reactions. IRIS associated with tuberculosis (TB) is well recognized among human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy, but it is less common among HIV-negative patients. IRIS can manifest as a paradoxical worsening or recurring of preexisting tuberculous lesions or development of new lesions despite successful antituberculous treatment. Hence, the condition might be misdiagnosed as superimposed infections, treatment failure, or relapse of TB. This pictorial essay reviewed diagnostic criteria and various thoracic manifestations of the paradoxical form of TB-associated IRIS (TB-IRIS) that might aid in early recognition of this clinical entity among HIV-negative patients. The treatment and outcomes of TB-IRIS were also discussed.
authors.affiliation: Division of Pulmonary and Critical Care, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok. pprapaporn@gmail.com.
authors.forename: Prapaporn
authors.initials: P
authors.lastname: Pornsuriyasak
authors.forename: Thitiporn
authors.initials: T
authors.lastname: Suwatanapongched
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013909:Thorax / Q000000981:diagnostic imaging* / Q000473:pathology; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000276:immunology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents