Unmasking Immune Reconstitution Inflammatory Syndrome (IRIS) Associated with Disseminated Penicilliosis in an AIDS Patient: First Adult Case in Thailand

Authors

  • Woraphot Tantisiriwat

Keywords:

Talaromyces marneffei, Penicillium marneffei, Penicilliosis, Immune reconstitution inflammatory syndrome (IRIS)

Abstract

A 16-year old Thai male with fever and weight loss for two weeks was diagnosed with AIDS (CD4 cell count 71 cells/mm3, HIV viral load 564,000 copies/mL). Complete blood count was normal, and blood cultures were negative. Antiretroviral therapy (ART) resulted in resolution of fever and weight gain. One week later, he developed a high fever, weight loss, jaundice, abdominal pain, and hepatosplenomegaly, but no umbilicated skin lesions or superficial lymphadenopathy. Investigations showed anemia, leukopenia, and transaminitis. CT scan demonstrated hepatosplenomegaly with microabscess formation and intra-abdominal lymphadenopathy. Hemocultures yielded Talaromyces marneffei (formerly Penicillium marneffei). Immune reconstitution inflammatory syndrome was suspected due to clinical deterioration after starting ART in a patient with low pretreatment CD4 cell count. This
is the first report of an adult AIDS patient with penicilliosis-associated IRIS in Thailand. A literature review and summary of 14 previously reported cases are included.

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Published

20-09-2017

How to Cite

Tantisiriwat, W. (2017). Unmasking Immune Reconstitution Inflammatory Syndrome (IRIS) Associated with Disseminated Penicilliosis in an AIDS Patient: First Adult Case in Thailand. Siriraj Medical Journal, 69(5), 300–305. Retrieved from https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/99636

Issue

Vol. 69 No. 5 (2017): September-October

Section

Case Report

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