{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:41:14Z","timestamp":1755794474037,"version":"3.44.0"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Ein 33-j\u00e4hriger Patient mit unbehandelter Humane Immundefizienz Virus (HIV)-Infektion wurde aufgrund einer akuten Lungenembolie mit h\u00e4modynamischer Einschr\u00e4nkung zur weiteren Behandlung \u00fcbernommen. Bei vorliegender B-Symptomatik (Fieber, Nachtschwei\u00df und Gewichtsverlust) ergaben sich zun\u00e4chst keine Hinweise auf ein Malignom und\/oder eine opportunistische Infektion. Sonografisch zeigten sich initial wenig Aszites ohne Nachweis einer spontan bakteriellen Peritonitis (SBP) bei zugrunde liegender Fettleberhepatitis mit Hypoprotein\u00e4mie und Rechtsherzdekompensation. Wir veranlassten die Einleitung einer antiretroviralen Therapie (ART). Es kam zu einem komplikativen Verlauf mit Entstehung einer fulminanten Peritonitis, die nicht auf eine breite antiinfektive Therapie ansprach. Im Weiteren zeigte sich eine respiratorische Verschlechterung mit progredienter Oxygenierungsst\u00f6rung. Differenzialdiagnostisch wurde ein Immunrekonstitutionssyndrom (IRIS) vermutet und im Verlauf zun\u00e4chst eine peritoneale und schlie\u00dflich eine offene Lungentuberkulose (TB) diagnostiziert.\n               Fazit Bei (hyper-)inflammatorischem Krankheitsbild unter neu begonnener ART sollte ein demaskierendes IRIS auf dem Boden einer bislang okkulten TB (TB-IRIS) fr\u00fchzeitig differenzialdiagnostisch in Erw\u00e4gung gezogen und gezielt therapiert werden. Vor Einleitung einer ART m\u00fcssen opportunistische Infektionen, insbesondere eine TB bei klinischem Verdacht ggf. auch mittels Biopsie, ausgeschlossen werden.<\/jats:p>","DOI":"10.1055\/a-2605-4347","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T20:03:31Z","timestamp":1748462611000},"page":"585-590","source":"Crossref","is-referenced-by-count":0,"title":["Demaskierendes Immunrekonstitutionssyndrom (IRIS) bei XDR-Tuberkulose-HIV-Koinfektion: ein Fallbericht"],"prefix":"10.1055","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1777-1322","authenticated-orcid":false,"given":"Sabrina","family":"Welland","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, Hepatologie, Infektiologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz 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