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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME MASQUERADING AS A LUNG MASS IN A KIDNEY TRANSPLANT RECIPIENT WITH DISSEMINATED CRYPTOCOCCAL INFECTION
Author
Fawad Virk1, Shahzaib Nabi1*, Adeel Arshad2, Mayur Ramesh3
Email
snabi1@hfhs.org
keyword
Cryptococcal meningitis, cryptococcal pneumonia, Immune reconstitution inflammatory syndrome.
Abstract
This is a case of a 57-year-old woman with a history of deceased donor kidney transplant, who presented with a headache and nonproductive cough. Cerebrospinal fluid findings were consistent with acute cryptococcal meningitis. Chest computed tomography showed an area of consolidation in the right lung suspected to be cryptococcal pneumonia. The patient was initiated on liposomal amphotericin and 5-flucytosine for disseminated cryptococcal infection, along with reduction of immunosuppression. Approximately 10 days after starting therapy, the patient’s cough worsened and repeat chest computed tomography revealed an interval enlargement of the area of consolidation. Bronchoalveolar lavage was negative for any infective etiology but consistent with immune reconstitution inflammatory syndrome. Antifungal therapy was continued with eventual improvement in symptoms afterwards. Early recognition is the key to proper management in patients with immune reconstitution inflammatory syndrome.
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