Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature
We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.
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Sociedade Brasileira de Medicina Tropical - SBMT
2014
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oai:scielo:S0037-868220140006008062015-01-20Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literatureLyra,Marcelo RosandiskiNascimento,Maria Letícia Fernandes OliveiraVaron,Andréa GinaPimentel,Maria Inês FernandesAntonio,Liliane de FátimaSaheki,Maurício NaotoBedoya-Pacheco,Sandro JavierValle,Antonio Carlos Francesconi do HIV Sporotrichosis Immune reconstitution inflammatory syndrome We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.info:eu-repo/semantics/openAccessSociedade Brasileira de Medicina Tropical - SBMTRevista da Sociedade Brasileira de Medicina Tropical v.47 n.6 20142014-12-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822014000600806en10.1590/0037-8682-0146-2014 |
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Lyra,Marcelo Rosandiski Nascimento,Maria Letícia Fernandes Oliveira Varon,Andréa Gina Pimentel,Maria Inês Fernandes Antonio,Liliane de Fátima Saheki,Maurício Naoto Bedoya-Pacheco,Sandro Javier Valle,Antonio Carlos Francesconi do |
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Lyra,Marcelo Rosandiski Nascimento,Maria Letícia Fernandes Oliveira Varon,Andréa Gina Pimentel,Maria Inês Fernandes Antonio,Liliane de Fátima Saheki,Maurício Naoto Bedoya-Pacheco,Sandro Javier Valle,Antonio Carlos Francesconi do Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature |
author_facet |
Lyra,Marcelo Rosandiski Nascimento,Maria Letícia Fernandes Oliveira Varon,Andréa Gina Pimentel,Maria Inês Fernandes Antonio,Liliane de Fátima Saheki,Maurício Naoto Bedoya-Pacheco,Sandro Javier Valle,Antonio Carlos Francesconi do |
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Lyra,Marcelo Rosandiski |
title |
Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature |
title_short |
Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature |
title_full |
Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature |
title_fullStr |
Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature |
title_full_unstemmed |
Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature |
title_sort |
immune reconstitution inflammatory syndrome in hiv and sporotrichosis coinfection: report of two cases and review of the literature |
description |
We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up. |
publisher |
Sociedade Brasileira de Medicina Tropical - SBMT |
publishDate |
2014 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822014000600806 |
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