{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T05:42:17Z","timestamp":1774849337188,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neurological immune reconstitution inflammatory syndrome (IRIS) in HIV can present variably. We report a case of steroid-dependent, recurrent cortical encephalitis with a distinctive migratory Magnetic Resonance Imaging (MRI) pattern following cryptococcal meningitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 38-year-old male with advanced HIV (CD4 11\/\u03bcL) developed cryptococcal meningitis. After antifungal induction and switching to effective antiretroviral therapy (bictegravir\/emtricitabine\/tenofovir alafenamide), he suffered recurrent neurological episodes. Serial brain MRIs showed sequentially appearing and resolving T2\/Fluid-Attenuated Inversion Recovery (FLAIR) hyperintensities in the bilateral frontal lobes, left cingulate gyrus, and left occipital cortex, despite negative infectious and autoimmune workup. Symptoms were steroid-responsive but relapsed upon tapering. Lasting remission was achieved only after adding mycophenolate mofetil (MMF), allowing corticosteroid withdrawal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case describes a \u201cmigratory cortical encephalitis\u201d phenotype of Central Nervous System (CNS)-IRIS. It highlights that cortical grey matter can be the primary target in severe IRIS and illustrates the utility of steroid-sparing agents like MMF for managing refractory, steroid-dependent neuroinflammation in this context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1805701","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T04:10:34Z","timestamp":1774843834000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Individualized immunotherapy for immune reconstitution-associated cortical encephalitis in an HIV-positive cryptococcal meningitis patient: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Wen","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Neurology Department, The First Affiliated Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8","article-title":"Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis","volume":"17","author":"Rajasingham","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63849-6.00013-X","article-title":"CNS immune reconstitution inflammatory syndrome","volume":"152","author":"Bowen","year":"2018","journal-title":"Handb Clin Neurol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1097\/QCO.0b013e32835c21d1","article-title":"Cryptococcal immune reconstitution inflammatory syndrome","volume":"26","author":"Longley","year":"2013","journal-title":"Curr Opin Infect 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