Pulmonary tuberculosis and immune reconstitution inflammatory syndrome
Presentation
Not specified.
Patient Data
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
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 antiretroviral therapy (ART), 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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