Pulmonary tuberculosis and immune reconstitution inflammatory syndrome

Case contributed by Dr Paul Leong

Presentation

Not specified.

Patient Data

Age: 46 years
Gender: Male

RML consolidation, with multiple small nodules throughout both lungs

RML consolidation with multiple small pulmonary nodules in the upper lobes.

There is also mediastinal lymphadenopathy, which demonstrates central low density suggestive of necrosis.

Right pleural effusion.

 

Findings are highly suggestive of active TB infection.

Follow-up x-ray study

Modality: X-ray

RML consolidation, multiple small pulmonary nodules and a right pleural effusion.

These findings have progressed since the initial imaging.

Case Discussion

The patient was diagnosed with HIV and pulmonary TB infection on admission.

Following commencement of HAART therapy, there was a clinical deterioration and worsening of the CXR findings. This correlated with an increase in the patient's CD4 count.

This pattern is consistent with an Immune Reconstitution Inflammatory Syndrome (IRIS).

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Case Information

rID: 26535
Case created: 27th Dec 2013
Last edited: 11th Apr 2016
System: Chest
Inclusion in quiz mode: Included

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