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The Immune Inflammatory Reconstitution Syndrome and Central Nervous System Toxoplasmosis
- Ivo W. Tremont-Lukats, MD;
- Pedro Garciarena, MD;
- Rubén Juarbe, MD; and
- Rima N. El-Abassi, MD
- From University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, and Louisiana State University, New Orleans, LA 70119.
Background: The immune inflammatory reconstitution syndrome (IRIS) is a paradoxical worsening of an opportunistic infection as CD4 cells proliferate because highly active antiretroviral therapy (HAART) engages antigenic epitopes and triggers an overshooting inflammatory response. A weak link exists between IRIS and the most frequent neurologic complication of AIDS, central nervous system (CNS) toxoplasmosis.
Objective: To show that IRIS can also occur in CNS toxoplasmosis and to share our approach to the problem.
Case Report: In early September 2008, we admitted a 30-year-old woman with headaches, imbalance, and left-sided weakness for 1 week. She had untreated HIV-1 infection diagnosed 6 months before admission. On examination, she had fever (38.9 °C) and oral thrush. Her mental status was normal, no papilledema was present, and she had left hemiparesis with the Babinski …
This 100-word excerpt has been provided in the absence of an abstract.
