Nerve abscess in Hansen's disease as part of immune reconstitution inflammatory syndrome: a case report.
Immune reconstitution inflammatory syndrome is an inflammatory reaction in HIV-infected patients after initiation of antiretroviral therapy resulting from restored immunity to specific infectious or non-infectious antigens. A 36-year-old male patient on highly active antiretroviral therapy of six months duration, presented with reddish, tender lesions over medial aspect of arm and a single, anaesthetic patch. Tender fluctuant swellings were seen on the medial aspect of left forearm. A few of them had ruptured spontaneously discharging pus. A skin biopsy from the anaesthetic patch showed caseating epitheloid granulomas. A diagnosis of Hansen's disease borderline tuberculoid in type 1 reversal reaction, with formation of nerve abscess due to Immune Reconstitution Inflammatory Syndrome was made. The patient was started on multibacillary multidrug therapy as per WHO guidelines and highly active antiretroviral therapy was continued.
1 Dept of Dermatology, Father Muller Medical College, Mangalore, India.
Neema M
NM
Ali
2 Dept of Dermatology, Kasturba Medical College, Mangalore, India.
Kashinath
K
Nayak
2 Dept of Dermatology, Kasturba Medical College, Mangalore, India.
Pramod
P
Kumar
D017088:AIDS-Related Opportunistic Infections / Q000139:chemically induced* / Q000188:drug therapy; D000038:Abscess / Q000188:drug therapy* / Q000209:etiology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001706:Biopsy; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications*; D007917:Leprostatic Agents / Q000627:therapeutic use; D015439:Leprosy, Borderline / Q000139:chemically induced* / Q000175:diagnosis; D015441:Leprosy, Tuberculoid / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D007917:Leprostatic Agents; D011239:Prednisolone
AIDS; Indian subcontinent; highly active antiretroviral therapy