Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Marcelo Rosandiski Lyra, Maria Letícia Fernandes Oliveira Nascimento, Andréa Gina Varon, Maria Inês Fernandes Pimentel, Liliane de Fátima Antonio, Maurício Naoto Saheki, Sandro Javier Bedoya-Pacheco, Antonio Carlos Francesconi do Valle
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2014
• Subjects: HIV; Sporotrichosis; Immune reconstitution inflammatory syndrome; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0146-2014; https://doaj.org/article/10670be647624ec498e7c3bef36f02b5

We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.