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A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome

Immune reconstitution inflammatory syndrome (IRIS) is a condition during the clinical course of HIV infection in which there is paradoxical worsening and/or new onset of opportunistic infections in a HIV-positive patient who has recently been started on anti-retroviral therapy (ART). We present a ca...

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Autores principales: Mitra, Debdeep, Singh, Gautam Kumar, Mitra, Barnali, Talukdar, Krishna, Dhillon, Amen, Singh, Tegveer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628094/
https://www.ncbi.nlm.nih.gov/pubmed/34909622
http://dx.doi.org/10.4103/ijstd.IJSTD_58_20
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author Mitra, Debdeep
Singh, Gautam Kumar
Mitra, Barnali
Talukdar, Krishna
Dhillon, Amen
Singh, Tegveer
author_facet Mitra, Debdeep
Singh, Gautam Kumar
Mitra, Barnali
Talukdar, Krishna
Dhillon, Amen
Singh, Tegveer
author_sort Mitra, Debdeep
collection PubMed
description Immune reconstitution inflammatory syndrome (IRIS) is a condition during the clinical course of HIV infection in which there is paradoxical worsening and/or new onset of opportunistic infections in a HIV-positive patient who has recently been started on anti-retroviral therapy (ART). We present a case of AIDS with CD4 count of 20 cells/μl who presented within 6 weeks of starting ART with a CD4 count of 160 cells/μl and a painless solitary genital ulcer along with annular dark-colored plaques over soles. His screening test for syphilis was negative both during baseline evaluation, prior to initiation of ART, and during his clinical presentation. His disease was confirmed based on a positive treponema pallidum hemagglutination test report and a suggestive skin biopsy. He responded well to three doses of Benzathine Penicillin and continuation of ART. There are very few case reports of syphilis presenting as IRIS and this case is all the more unique as he had features of both primary and secondary syphilis occurring together within 6 weeks of starting ART. This report would reiterate the fact that syphilis and HIV co-infection can alter the natural course of both the diseases and a high index of suspicion is required for treating them.
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spelling pubmed-86280942021-12-13 A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome Mitra, Debdeep Singh, Gautam Kumar Mitra, Barnali Talukdar, Krishna Dhillon, Amen Singh, Tegveer Indian J Sex Transm Dis AIDS Case Report Immune reconstitution inflammatory syndrome (IRIS) is a condition during the clinical course of HIV infection in which there is paradoxical worsening and/or new onset of opportunistic infections in a HIV-positive patient who has recently been started on anti-retroviral therapy (ART). We present a case of AIDS with CD4 count of 20 cells/μl who presented within 6 weeks of starting ART with a CD4 count of 160 cells/μl and a painless solitary genital ulcer along with annular dark-colored plaques over soles. His screening test for syphilis was negative both during baseline evaluation, prior to initiation of ART, and during his clinical presentation. His disease was confirmed based on a positive treponema pallidum hemagglutination test report and a suggestive skin biopsy. He responded well to three doses of Benzathine Penicillin and continuation of ART. There are very few case reports of syphilis presenting as IRIS and this case is all the more unique as he had features of both primary and secondary syphilis occurring together within 6 weeks of starting ART. This report would reiterate the fact that syphilis and HIV co-infection can alter the natural course of both the diseases and a high index of suspicion is required for treating them. Wolters Kluwer - Medknow 2021 2021-07-27 /pmc/articles/PMC8628094/ /pubmed/34909622 http://dx.doi.org/10.4103/ijstd.IJSTD_58_20 Text en Copyright: © 2021 Indian Journal of Sexually Transmitted Diseases and AIDS https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Mitra, Debdeep
Singh, Gautam Kumar
Mitra, Barnali
Talukdar, Krishna
Dhillon, Amen
Singh, Tegveer
A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome
title A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome
title_full A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome
title_fullStr A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome
title_full_unstemmed A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome
title_short A case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome
title_sort case of primary and secondary syphilis presenting together as immune reconstitution inflammatory syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628094/
https://www.ncbi.nlm.nih.gov/pubmed/34909622
http://dx.doi.org/10.4103/ijstd.IJSTD_58_20
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