Paradoxical worsening of chest radiographs secondary to immune reconstitution syndrome (IRIS) in a patient with advanced HIV infection and Rhodococcus pneumonia

Author: Kwee Choy Koh ¹ ; Nur Munirah Ibrahim ² ; Sidney Ching Liang Ong ¹
Author Information

1. Department of Internal Medicine, International Medical University, Seremban, Negeri Sembilan, Malaysia
2. Department of Medicine, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia
Publication Type:Case Reports
From: The Medical Journal of Malaysia 2020;75(2):164-166
CountryMalaysia
Language:English
Abstract: We present a rare case of post-antiretroviral therapy (ART) paradoxically worsening of radiological findings in a patient with advanced HIV-infection on treatment for Rhodococcus pneumonia who was misdiagnosed with pulmonary tuberculosis. Despite clinical improvement, serial chest radiographs showed deteriorations a month after starting ART. This was attributed to Immune Reconstitution Inflammatory Syndrome (IRIS) which spontaneously resolved without any treatment.