CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 2: discussion of neuro-immune reconstitution inflammatory syndrome with and without other pathogens.

Abstract

SUMMARY:

While the previous review of CNS-IRIS in the HIV-infected patient on highly active antiretroviral therapy (Part 1) dealt with an overview of the biology, pathology, and neurologic presentation of this condition and a discussion of the atypical imaging findings in PML-IRIS and cryptococcal meningitis-IRIS due to the robust inflammatory response, the current review (Part 2) discusses the imaging findings in other commonly encountered organisms seen in association with CNS-IRIS, namely, VZV, CMV, HIV, Candida organisms, Mycobacterium tuberculosis, and Toxoplasma gondii. Also described is the imaging appearance of CNS-IRIS when not associated with a particular organism. Recognition of these imaging findings will give credence to the diagnosis of CNS-IRIS and will allow the clinician to institute changes in medical management, if necessary, so that immune reconstitution and improved patient outcome can occur with time.

• Authors: M J D Post, M M Thurnher, D B Clifford, A Nath, R G Gonzalez, R K Gupta, K K Post
• Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 34 Issue 7 Pg. 1308-18 (Jul 2013) ISSN: 1936-959X [Electronic] United States
• PMID: 22790252 (Publication Type: Journal Article, Review)

Topics

• AIDS-Related Opportunistic Infections (diagnosis)
• Antiretroviral Therapy, Highly Active
• Candidiasis (diagnosis)
• Central Nervous System Diseases (immunology)
• Central Nervous System Fungal Infections (diagnosis)
• Central Nervous System Infections (diagnosis)
• Central Nervous System Viral Diseases (diagnosis)
• HIV Infections (drug therapy)
• Herpesviridae Infections (diagnosis)
• Humans
• Immune Reconstitution Inflammatory Syndrome (diagnosis)
• Toxoplasmosis, Cerebral (diagnosis)
• Tuberculosis, Central Nervous System (diagnosis)