Open AccessNannizziopsis Immune Reconstitution Inflammatory Syndrome in a Patient with HIV: First Reported Case
Author(s) -
Yi Zhao,
Mikhail Nozdrin,
Alessia Dalla Pria,
Margherita Bracchi
Publication year - 2021
Publication title -
european journal of case reports in internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2284-2594
DOI - 10.12890/2021_003021
Subject(s) - medicine , immune reconstitution inflammatory syndrome , voriconazole , lesion , hemiparesis , human immunodeficiency virus (hiv) , immune system , lung , antiretroviral therapy , surgery , immunology , viral load , antifungal , dermatology
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.