Brain tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-positive patient: a biopsy-proven case

  • Maria Letizia Giancola National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Francesco Baldini National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Carmine Maria Carapella Department Neuroscience, Regina Elena National Cancer Institute, Rome, Italy
  • Elisa Busi Rizzi National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy
  • Rita Maddaluno National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Lucia Alba National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
  • Andrea Antinori National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
Keywords: HIV, tuberculosis, tuberculoma, immune reconstitution inflammatory syndrome (IRIS), antiretroviral therapy, central nervous system

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.

Published
2015-05-18
How to Cite
1.
Giancola ML, Baldini F, Carapella CM, Busi Rizzi E, Maddaluno R, Alba L, Antinori A (2015) Brain tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-positive patient: a biopsy-proven case. J Infect Dev Ctries 9:536-540. doi: 10.3855/jidc.5552
Section
Case Reports