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Treatment with ceftriaxone resulted in clinical deterioration with fever, arthritis and recurrent pleuritis consistent with immune reconstitution inflammatory syndrome. Dose increase of glucocorticoids and therapy rotation to doxycycline and hydroxychloroquine resulted in rapid clinical improvement.<\/jats:p>","DOI":"10.1136\/bcr-2021-243633","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T13:10:20Z","timestamp":1624021820000},"page":"e243633","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Granulomatous lung disease and immune reconstitution inflammatory syndrome in Whipple\u2019s disease"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4586-641X","authenticated-orcid":false,"given":"Patrick","family":"Hofmann","sequence":"first","affiliation":[{"name":"Internal Medicine, Hospital Uster, Uster, Switzerland"},{"name":"Institute of Physiology, University of Zurich, Zurich, 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