Granulomatous interstitial nephritis in the setting of disseminated Mycobacterium simiae: a rare presentation of immune reconstitution inflammatory syndrome

Abstract

<jats:p> Disseminated Mycobacterium simiae is a rare opportunistic infection reported most commonly in advanced human immunodeficiency virus (HIV) infection. Treatment can be further complicated by the occurrence of severe immune reconstitution inflammatory syndrome (IRIS). We present the first case of disseminated multi-drug-resistant M. simiae in the setting of advanced HIV, complicated by IRIS in the form of granulomatous interstitial nephritis causing acute renal failure. This case highlights the importance of recognizing rare complications of IRIS, as delays in therapy can be life threatening. </jats:p>

Treatment management of M. simiae infection complicated by severe immune reconstitution syndrome in two patients living with HIV

“…31 In another case, IRIS in the setting of disseminated M. simiae resulted in renal failure due to granulomatous interstitial nephritis. 32 IRIS associated with M. simiae may present as severe cases and have several clinical presentations including, intra-abdominal lymphadenopathy, large masses causing organ dysfunction and transaminitis, 22 granulomatous nephritis, 32 and central nervous system involvement. 33 There is limited guidance for the management of IRIS in these clinical scenarios.…”