Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome Manifested As Multiple Central Nervous System Granulomas In Non-HIV Patient: A Case Report

Abstract Background: In addition to developed in HIV patient during highly active antiretroviral therapy, immune reconstitution inflammatory syndrome (IRIS) has also been well recognized in non-HIV immunocompromised patients induced by latent viruses, untreated microorganisms, or treating microorganisms. Mycobacteria tuberculosis is one of the most common pathogens inducing IRIS. Case presentation: Here, we report a tuberculosis patient progressed with IRIS that additional central nervous system (CNS) granuloma occurred during the anti-tuberculosis treatment (ATT) process with her pulmonary symptoms improved after quadruple anti-tuberculosis. This case highlights the need to increase the awareness of IRIS in non-HIV immunocompromised patients. Conclusions: TB-IRIS must be considered when the condition deteriorates or development of new lesions at distant sites in the course of ATT. Early identification and diagnosis help to handle timely and correctly.