Antiretroviral therapy-induced paradoxical worsening of previously healed Mycobacterium haemophilum cutaneous lesions in advanced HIV infection
| Autor: | Ícaro Rodrigues-dos-Santos, Luciana Ferreira de Araujo, Sidra Ezidio Gonçalves Vasconcellos, Carlos José Martins, Harrison Magdinier-Gomes, Carlos Alberto Basílio-de-Oliveira, Marcelo Costa Velho Mendes de Azevedo, Walter de Araujo Eyer-Silva, Rodrigo Panno Basílio-de-Oliveira, Marina Rodrigues de Almeida, Jorge Francisco da Cunha Pinto, Philip Noel Suffys |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
RC955-962 030231 tropical medicine Human immunodeficiency virus (HIV) Case Report medicine.disease_cause Nontuberculous mycobacterium 03 medical and health sciences 0302 clinical medicine Immune reconstitution inflammatory syndrome Acquired immunodeficiency syndrome (AIDS) Immune Reconstitution Inflammatory Syndrome Arctic medicine. Tropical medicine medicine Disseminated disease biology business.industry medicine.disease biology.organism_classification HIV infection Dermatology Antiretroviral therapy Mycobacterium haemophilum AIDS Complication business |
| Zdroj: | Revista do Instituto de Medicina Tropical de São Paulo Revista do Instituto de Medicina Tropical de São Paulo, Vol 61 (2019) |
| ISSN: | 1678-9946 0036-4665 |
| Popis: | Mycobacterium haemophilum is a nontuberculous mycobacterium that causes localized or disseminated disease, mainly in immunocompromised hosts. We report the case of a 35-year-old HIV-infected woman who presented with several enlarging cutaneous lesions over the arms and legs. Histopathological examination revealed the diagnosis of a cutaneous mycobacterial disease. Mycobacterial analyses unveiled M. haemophilum infection. Six months after completion of a successful antimycobacterial treatment, she developed an immune reconstitution inflammatory syndrome (IRIS). This paradoxical relapse presented as tenderness, redness and swelling at the precise sites of the healed lesions and took place in the setting of significant recovery of the CD4 cell count (from 05 to 318 cells/mm 3 ). Microbiological analyses of these worsening lesions were negative, and they spontaneously remitted without the initiation of a novel antimycobacterial treatment cycle. M. haemophilum infection should always be considered as a cause of skin lesions in immunocompromised subjects. Physicians should be aware of the possibility of IRIS as a complication of successful antiretroviral therapy in HIV-infected patients with M. haemophilum infection. |
| Databáze: | OpenAIRE |
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