Cryptococcal meningoencephalitis relapse after an eight-year delay: an interplay of infection and immune reconstitution
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Cryptococcal meningoencephalitis relapse after an eight-year delay: an interplay of infection and immune reconstitution. / Katchanov, Juri; Blechschmidt, Cristiane; Nielsen, Kirsten; Branding, Gordian; Arastéh, Keikawus; Tintelnot, Kathrin; Meintjes, Graeme; Boulware, David R; Stocker, Hartmut.
In: INT J STD AIDS, Vol. 26, No. 12, 10.2015, p. 912-4.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Cryptococcal meningoencephalitis relapse after an eight-year delay: an interplay of infection and immune reconstitution
AU - Katchanov, Juri
AU - Blechschmidt, Cristiane
AU - Nielsen, Kirsten
AU - Branding, Gordian
AU - Arastéh, Keikawus
AU - Tintelnot, Kathrin
AU - Meintjes, Graeme
AU - Boulware, David R
AU - Stocker, Hartmut
N1 - © The Author(s) 2015.
PY - 2015/10
Y1 - 2015/10
N2 - We report a case of a symptomatic relapse of HIV-related cryptococcal meningoencephalitis eight years after the first diagnosis on the background of immune reconstitution. The findings as well as the clinical course suggests a combination of smouldering localised infection and enhanced inflammatory reaction related to immune restoration due to antiretroviral therapy. A combination of antifungal and anti-inflammatory therapy resulted in clinical and radiological improvement. Our case challenges the concept that immune reconstitution inflammatory syndrome and microbiological relapse are dichotomous entities.
AB - We report a case of a symptomatic relapse of HIV-related cryptococcal meningoencephalitis eight years after the first diagnosis on the background of immune reconstitution. The findings as well as the clinical course suggests a combination of smouldering localised infection and enhanced inflammatory reaction related to immune restoration due to antiretroviral therapy. A combination of antifungal and anti-inflammatory therapy resulted in clinical and radiological improvement. Our case challenges the concept that immune reconstitution inflammatory syndrome and microbiological relapse are dichotomous entities.
KW - AIDS-Related Opportunistic Infections
KW - Anti-HIV Agents
KW - Antifungal Agents
KW - Antiretroviral Therapy, Highly Active
KW - Biopsy
KW - Brain
KW - Cryptococcus neoformans
KW - Female
KW - Fluconazole
KW - HIV Infections
KW - Humans
KW - Immune Reconstitution Inflammatory Syndrome
KW - Male
KW - Medication Adherence
KW - Meningitis, Cryptococcal
KW - Recurrence
KW - Treatment Outcome
U2 - 10.1177/0956462414563630
DO - 10.1177/0956462414563630
M3 - SCORING: Journal article
C2 - 25505049
VL - 26
SP - 912
EP - 914
JO - INT J STD AIDS
JF - INT J STD AIDS
SN - 0956-4624
IS - 12
ER -