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Immune Reconstitution Inflammatory Syndrome Presenting as Superior Vena Cava Syndrome Secondary to Coccidioides Lymphadenopathy in an HIV-Infected Patient

Department of Family Medicine University of California, San Francisco-Fresno Medical Education Program, Fresno, California, rmortimer{at}fresno.ucsf.edu

Robert Libke, MD

Department of Internal Medicine University of California, San Francisco-Fresno Medical Education Program, Fresno, California

Babak Eghbalieh, MD

Department of Surgery University of California, San Francisco-Fresno Medical Education Program, Fresno, California

John F. Bilello, MD

Department of Surgery University of California, San Francisco-Fresno Medical Education Program, Fresno, California

A 39-year-old man living with AIDS presented with a swollen face. He was found to be HIV infected after presenting with Coccidioides pneumonia 2 years previously and was placed on daily fluconazole and then on highly active antiretroviral therapy. Computed tomography confirmed superior vena cava obstruction secondary to lymphadenopathy. Biopsy confirmed coccidioidomycosis with no evidence of malignancy. To our knowledge, this is the first description of superior vena cave syndrome secondary to coccidioidomycosis and the first description of immune reconstitution inflammatory syndrome involving Coccidioides.

Key Words: coccidioidomycosis • immune reconstitution inflammatory syndrome • superior vena cava syndrome • HIV • AIDS

This version was published on December 1, 2008

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 7, No. 6, 283-285 (2008)
DOI: 10.1177/1545109708326090


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