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Pulmonary and Prolonged Hepatosplenic Immune Reconstitution Inflammatory Syndrome in a Patient With HIV Infection and Tuberculosis

Siegel, Marc MD; Benator, Debra MD

Infectious Diseases in Clinical Practice: July 2009 - Volume 17 - Issue 4 - p 270-273
doi: 10.1097/IPC.0b013e31818d1ad3
Case Reports

Immune reconstitution inflammatory syndrome (IRIS) has been widely reported in patients with recognized and unrecognized opportunistic infections who are started on antiretroviral therapy (ART). It has most commonly been seen in association with mycobacterial infections, particularly Mycobacterium tuberculosis infections (Lawn et al. Lancet Infect Dis. 2005;5:361-373). Pulmonary and lymphatic IRIS has been well documented in HIV and tuberculosis (TB) coinfected patients receiving anti-TB therapy who are started on ART. However, intra-abdominal IRIS in these individuals has been less frequently been reported. We report an unusual case of pulmonary and hepatosplenic IRIS presenting in an HIV-infected patient restarting ART while being treated for TB.

From the Division of Infectious Diseases, George Washington University Medical Center; and Division of Infectious Diseases, VA Medical Center, Washington, DC.

Reprints: Marc Siegel, MD, 6651 Hillandale Rd, Chevy Chase, MD 20815. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.