Nannizziopsis Immune Reconstitution Inflammatory Syndrome in a Patient with HIV: First Reported Case

Yi Zhao; Mikhail  Nozdrin; Alessia  Dalla Pria; Margherita  Bracchi

doi:10.12890/2021_003021

Yi Zhao
Imperial College London School of Medicine, London, UK https://orcid.org/0000-0002-4563-4344
Mikhail Nozdrin
Department of Infectious Diseases, Imperial College London, London, UK https://orcid.org/0000-0001-6740-274X
Alessia Dalla Pria
Department of Infectious Diseases, Imperial College London, London, UK; Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK https://orcid.org/0000-0002-4563-4344
Margherita Bracchi
Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK

Keywords

HIV, immune reconstitution inflammatory syndrome, IRIS, Nannizziopsis

Abstract

We describe the case of a 35-year-old HIV-positive male of African origin diagnosed with neurotoxoplasmosis and a Nannizziopsis spp. cavitating pulmonary lesion unmasking immune reconstitution inflammatory syndrome (IRIS).

The patient presented with headache, left hemiparesis and confusion. MRI of the brain showed two space-occupying lesions in the right basal ganglia and left parietal lobe typical for neurotoxoplasmosis. The patient tested positive for HIV and had advanced CD4 lymphopenia. After commencement of antiretroviral treatment, a CT scan of the chest showed a cavitating lesion in the right upper lobe. The diagnosis of Nannizziopsis spp. fungal infection was confirmed by DNA sequencing on a bronchial wash sample. The patient achieved complete recovery with antiretroviral therapy, standard neurotoxoplasmosis treatment and antifungal treatment with voriconazole for 12 weeks.

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References

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Published: 2021-11-23
Issue: 2021: Vol 8 No 11 (view)

How to cite:

1.

Zhao Y, Nozdrin M, Dalla Pria A, Bracchi M. Nannizziopsis Immune Reconstitution Inflammatory Syndrome in a Patient with HIV: First Reported Case. EJCRIM 2021;8 doi:10.12890/2021_003021.