What is it about?
The confirmation of immune reconstitution inflammatory syndrome caused by tuberculosis is a diagnosis of exclusion that heavily relies on case definition with clinical data. Given that this can delay appropriate management and that there are limited treatment options, an in-depth understanding of this phenomenon will increase clinician awareness and help with faster diagnosis and more effective management.
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Why is it important?
Immune reconstitution inflammatory syndrome and paradoxical reactions to tuberculosis are rarely linked in individuals who are not infected with human immunodeficiency virus (HIV). Tuberculosis involvement is also rarely seen in the wrist joint. This article highlights these uncommon occurrences in an immunosuppressed HIV-seronegative individual.
Perspectives
Even though the mortality rate of paradoxical tuberculosis immune reconstitution inflammatory syndrome recorded is relatively low, patients can deteriorate rapidly and become critically unwell. A delay in diagnosis can occur because of a low suspicion index in HIV-seronegative patients. A better understanding of paradoxical tuberculosis-immune reconstitution inflammatory syndrome, increased clinician awareness, and knowledge of associated risk factors could prevent unnecessary treatments leading to faster diagnosis and effective patient management.
Nicole Ong Mingjing
Read the Original
This page is a summary of: Where you least expect it: paradoxical tuberculosis-immune reconstitution inflammatory syndrome and wrist joint tuberculosis as the initial manifestation in a patient who is HIV-seronegative, British Journal of Hospital Medicine, December 2023, Mark Allen Group,
DOI: 10.12968/hmed.2022.0407.
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