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Six weeks later, the patient presented with clinical worsening of known symptoms, new appearance of focal neurological deficits and progress of radiological features showing progression of the paravertebral abscess. Immune reconstitution inflammatory syndrome with <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (TB-IRIS) was presumed, and treatment with high-dose steroids was started. Due to recurrent relapses while tapering, corticosteroids had to be given over a prolonged period. After treatment completion, the patient was in a good general condition, abscesses had decreased and neurological deficits were in complete remission. This case presents the rare manifestation of TB-IRIS in HIV-negative patients and its management in a high-income country.<\/jats:p>","DOI":"10.1136\/bcr-2019-232639","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T13:00:45Z","timestamp":1629205245000},"page":"e232639","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Approach for tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-negative patient"],"prefix":"10.1136","volume":"14","author":[{"given":"Mich\u00e8le Rebecca","family":"Weber","sequence":"first","affiliation":[{"name":"Internal Medicine, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Sven","family":"Fehr","sequence":"additional","affiliation":[{"name":"Divison of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e9lix Pierre","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Medizinisch Radiologisches Institut, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa Brigitta","family":"Kaelin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"2025082702275380000_14.8.e232639.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70184-1"},{"key":"2025082702275380000_14.8.e232639.2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jctube.2016.03.002","article-title":"Tuberculosis-immune reconstitution inflammatory syndrome","volume":"3","author":"Lanzafame","year":"2016","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"2025082702275380000_14.8.e232639.3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s11908-012-0308-y","article-title":"The immune reconstitution inflammatory syndrome: a clinical update","volume":"15","author":"Armstrong","year":"2013","journal-title":"Curr Infect Dis Rep"},{"key":"2025082702275380000_14.8.e232639.4","doi-asserted-by":"crossref","first-page":"476","DOI":"10.4103\/0019-5154.87114","article-title":"The immune reconstitution inflammatory syndrome","volume":"56","author":"Bosamiya","year":"2011","journal-title":"Indian J Dermatol"},{"key":"2025082702275380000_14.8.e232639.5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2003.019224"},{"key":"2025082702275380000_14.8.e232639.6","doi-asserted-by":"crossref","first-page":"134","DOI":"10.5152\/dir.2014.14212","article-title":"Thoracic manifestations of paradoxical immune reconstitution inflammatory syndrome during or after antituberculous therapy in HIV-negative patients","volume":"21","author":"Pornsuriyasak","year":"2015","journal-title":"Diagn Interv Radiol"},{"key":"2025082702275380000_14.8.e232639.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2014.12.030"},{"key":"2025082702275380000_14.8.e232639.8","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.15.9"},{"key":"2025082702275380000_14.8.e232639.9","unstructured":"World Health Organization . 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