The introduction of antiretroviral therapy (ART) may lead to unusual paradoxical and unmasking presentations of opportunistic infections. Intra-abdominal cryptococcosis is a rare manifestation of Cryptococcus. We present the case of an HIV-infected patient on ART, with a history of cryptococcal meningitis who presented with subacute, worsening abdominal pain during immune recovery. This evolved into chronic abdominal pain, with thickened bowel, and abdominal lymphadenopathy, while receiving empiric tuberculosis treatment. At 6-months, he developed intestinal perforation due to a histologically confirmed cryptococcoma.
Bibliographical noteFunding Information:
We thank Ms. Jane Ndyetukira and Ms. Irene Namugga for patient care. This work was supported in part by the NIH National Institute of Allergy and Infectious Diseases, United States ( R25TW009345 ; T32AI055433 ; U01AI089244 ; K23AI073192 ; K24AI096925 ), Minnesota Medical Foundation through the Robert and Mabel Bohjanen Immune Reconstitution Research Fund, Tibotec REACH Initiative, University of Minnesota Translational Research Grant, University of Minnesota Office of International Programs.
- Antiretroviral therapy
- Cryptococcal meningitis
- Immune reconstitution inflammatory syndrome