Isolated cryptococcal osteomyelitis in the setting of immune reconstitution inflammatory syndrome.
Pamela Horton EmbreyAlexandra LongRasha AlfattalSuimin QiuJoseph Patrik HornakPublished in: Therapeutic advances in infectious disease (2024)
Cryptococcal infections, though rare, must be considered in all immunocompromised patients. Patients with HIV/AIDS on antiretrovirals may have a treatment course complicated by immune reconstitution inflammatory syndrome. Here we present a case of a 38-year-old woman with HIV/AIDS with knee pain who only began to experience severe pain after induction of antiretroviral therapy. She was found to have cryptococcal osteomyelitis without dissemination to the central nervous system, an unusual presentation for immunocompromised patients. She was treated with oral fluconazole with a resolution of symptoms. This case report suggests conservative management of isolated cryptococcal infection with fluconazole, regardless of immune status.
Keyphrases
- hiv aids
- antiretroviral therapy
- end stage renal disease
- case report
- newly diagnosed
- chronic kidney disease
- ejection fraction
- hiv infected
- human immunodeficiency virus
- peritoneal dialysis
- chronic pain
- total knee arthroplasty
- oxidative stress
- hiv infected patients
- neuropathic pain
- intensive care unit
- patient reported outcomes
- hepatitis c virus
- knee osteoarthritis
- patient reported
- mechanical ventilation