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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Main Authors: 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
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Medicina Tropical - SBMT 2014
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822014000600806
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spelling 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
institution SCIELO
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libraryname SciELO
language English
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author 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
spellingShingle 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
author_sort 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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