title: Brain tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-positive patient: a biopsy-proven case.
abstract: The case of an HIV-infected man from Eritrea previously diagnosed with tuberculosis, who presented neurological impairment and cerebral lesion after having voluntarily stopped anti-tubercular and antiretroviral therapies, is here reported. Treatments associated with steroids and mannitol were administered. The patient's condition improved, but neuroimaging showed a continuous worsening of the lesion, while a great immunological reconstitution was observed. Brain microsurgery was performed. A tuberculosis diagnosis was supported by pathological and microbiological examinations. Tuberculosis arising during immune reconstitution inflammatory syndrome is a complication of antiretroviral treatment and is considered to be an emerging disorder, especially in countries highly endemic for tuberculosis.
authors.affiliation: National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy. mletizia.giancola@inmi.it.
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Giancola
authors.forename: Francesco
authors.initials: F
authors.lastname: Baldini
authors.forename: Carmine Maria
authors.initials: CM
authors.lastname: Carapella
authors.forename: Elisa
authors.initials: E
authors.lastname: Busi Rizzi
authors.forename: Rita
authors.initials: R
authors.lastname: Maddaluno
authors.forename: Lucia
authors.initials: L
authors.lastname: Alba
authors.forename: Andrea
authors.initials: A
authors.lastname: Antinori
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D001921:Brain / Q000473:pathology; D019017:Eritrea; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis* / Q000473:pathology*; D007558:Italy; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000473:pathology*
chemical_list: D044966:Anti-Retroviral Agents