Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru.
Universidad Nacional Mayor de San Marcos, Lima, Peru.
J Int Assoc Provid AIDS Care. 2024 Jan-Dec;23:23259582241293302. doi: 10.1177/23259582241293302.
Immune reconstitution inflammatory syndrome is a common manifestation in human immunodeficiency virus (HIV)-positive patients infected with tuberculosis (TB). One of the unusual complications of this condition is the development of psoas abscess. We describe a case of immune reconstitution inflammatory syndrome (IRIS) in a patient with disseminated TB under treatment, HIV-positive with a low CD4 cell count, complicated by bilateral psoas abscess. Our patient presented with fever, abdominal pain, and lymphadenopathy, typical symptoms of TB-IRIS. Diagnosis was confirmed by surgical drainage of the abscess of the right iliac psoas muscle with detection of acid-fast bacteria on Ziehl-Neelsen staining and negative culture of purulent discharge. Treatment with prednisone was started in addition to continuation of antituberculosis therapy and antiretroviral therapy.
免疫重建炎症综合征是人类免疫缺陷病毒（HIV）阳性合并结核（TB）感染患者的常见表现。这种情况下的一种不常见并发症是腰大肌脓肿的发生。我们描述了一例 HIV 阳性、CD4 细胞计数低的播散性结核患者在治疗过程中发生免疫重建炎症综合征（IRIS），并合并双侧腰大肌脓肿。我们的患者表现为发热、腹痛和淋巴结病，这些都是结核-IRIS 的典型症状。通过对右侧髂腰肌脓肿进行手术引流，并在齐-尼染色上发现抗酸杆菌且脓性分泌物培养阴性，从而确诊。除了继续抗结核治疗和抗逆转录病毒治疗外，还开始使用泼尼松进行治疗。
