Paradoxical cryptococcal immune reconstitution inflammatory syndrome in advanced chronic kidney disease
Journal
International Urology and Nephrology
Journal Volume
45
Journal Issue
5
Pages
1505-1509
Date Issued
2013
Author(s)
Abstract
Cryptococcal-related immune reconstitution inflammatory syndrome (IRIS) is frequently seen in immunocompromised patients. A 45-year-old man with advanced chronic kidney disease (CKD) received intensive antifungal treatment for pulmonary cryptococcosis. Despite negative pleural effusion cultures and declining serum cryptococcal antigen titers, the patient presented with progressive pulmonary infiltration, intermittent fever, and elevated C-reactive protein. Steroids were given for suspected IRIS, and the clinical condition improved dramatically. This is the first report on paradoxical cryptococcal IRIS in a patient with advanced CKD. ? 2012 Springer Science+Business Media, B.V.
SDGs
Other Subjects
amphotericin B; C reactive protein; fluconazole; flucytosine; lactate dehydrogenase; methylprednisolone; protein; adult; article; case report; chronic kidney disease; computer assisted tomography; cryptococcosis; Cryptococcus neoformans; diabetic nephropathy; drug substitution; drug withdrawal; dyspnea; empyema; fever; fungus culture; heart failure; heart left ventricle ejection fraction; human; hypertension; immune reconstitution inflammatory syndrome; loading drug dose; lung infiltrate; male; oxygen desaturation; pleura effusion; pleura empyema; pulmonary cryptococcosis; thoracocentesis; thorax radiography; Anti-Inflammatory Agents; Antifungal Agents; Cryptococcosis; Cryptococcus neoformans; Humans; Immune Reconstitution Inflammatory Syndrome; Lung Diseases; Male; Methylprednisolone; Middle Aged; Renal Insufficiency, Chronic
Type
journal article