{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:01:36Z","timestamp":1760241696236,"version":"build-2065373602"},"reference-count":8,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2018,7,28]],"date-time":"2018-07-28T00:00:00Z","timestamp":1532736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Cryptococcosis is a fungal infection that is typically associated with acquired immunodeficiency syndrome (AIDS). The advent of highly active antiretroviral therapy has decreased the frequency of this infection, but has led to the emergence of atypical cases of immune reconstitution inflammatory syndrome (IRIS). Here, we describe the case of a 40-year-old man who was diagnosed with HIV infection and cryptococcal meningitis. He was successfully treated with antifungals and then started antiretroviral therapy. The patient returned to the hospital 15 months later complaining of fever, pain, and neck swelling. A computed tomography (CT) scan revealed a conglomerate of necrotic lymph nodes in the supraclavicular region. He underwent biopsy and histology showed granulomatous inflammation with fungal elements, consistent with Cryptococcus. He tested positive for serum cryptococcal antigen. The patient was treated with liposomal amphotericin and flucytosine. After induction therapy, he was re-started on fluconazole. The final fungal cultures were negative. We attributed our patient\u2019s clinical presentation to \u201cparadoxical\u201d IRIS, which was associated with his previously treated cryptococcosis. Near resolution of the supraclavicular mass was noted at the 3-month follow-up.<\/jats:p>","DOI":"10.3390\/diseases6030070","type":"journal-article","created":{"date-parts":[[2018,7,30]],"date-time":"2018-07-30T11:55:08Z","timestamp":1532951708000},"page":"70","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cryptococcal Lymphadenitis in an HIV-Infected Patient: A Rare Manifestation of Immune Reconstitution Inflammatory Syndrome"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2768-9712","authenticated-orcid":false,"given":"Jose Armando","family":"Gonzales Zamora","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yogeeta","family":"Varadarajalu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1177\/039463200802100332","article-title":"Cryptococcal lymphadenitis as a manifestation of immune reconstitution inflammatory syndrome in an HIV-positive patient: A case report and review of the literature","volume":"21","author":"Putignani","year":"2008","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"664","DOI":"10.3109\/00365548.2011.574293","article-title":"Cryptococcal lymphadenitis and immune reconstitution inflammatory syndrome: Current considerations","volume":"43","author":"Kuttiatt","year":"2011","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E178","DOI":"10.1111\/j.1439-0507.2010.01870.x","article-title":"Immune reconstitution inflammatory syndrome (IRIS) associated with Cryptococcus neoformans infection in AIDS patients","volume":"54","author":"Mora","year":"2011","journal-title":"Mycoses"},{"key":"ref_4","first-page":"137","article-title":"A rare case of primary supraclavicular lymphadenitis due to cryptococcus neoformans in an hiv infected patient","volume":"8","author":"Sood","year":"2014","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/qjmed\/hcp134","article-title":"Cervical lymphadenitis caused by Cryptococcus-related immune reconstitutional inflammatory syndrome","volume":"103","author":"Tsai","year":"2010","journal-title":"QJM"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ijid.2013.08.012","article-title":"Multiphasic and multifocal cryptococcal immune reconstitution inflammatory syndrome in an HIV-infected patient: Interplay of infection and immunity","volume":"18","author":"Katchanov","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E289","DOI":"10.1016\/j.jinf.2005.02.031","article-title":"Cryptococcal immune reconstitution inflammatory syndrome: Report of four cases in three patients and review of the literature","volume":"51","author":"Skiest","year":"2005","journal-title":"J. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1002\/dc.21805","article-title":"Cryptococcal lymphadenitis in HIV: A chance diagnosis by FNAC","volume":"41","author":"Bhuyan","year":"2013","journal-title":"Diagn. Cytopathol."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/6\/3\/70\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:14:55Z","timestamp":1760195695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/6\/3\/70"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,28]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,9]]}},"alternative-id":["diseases6030070"],"URL":"https:\/\/doi.org\/10.3390\/diseases6030070","relation":{},"ISSN":["2079-9721"],"issn-type":[{"type":"electronic","value":"2079-9721"}],"subject":[],"published":{"date-parts":[[2018,7,28]]}}}