CTICasesImmune Reconstitution Inflammatory Syndrome (IRIS)
Imaging findings
CT in a patient with a new diagnosis of HIV shortly after starting antiretroviral therapy (ART) shows diffuse, tiny nodules, septal lines, and mild pleural effusion, mimicking miliary infection. A follow-up scan shows complete clearing of the nodules and edema after the syndrome resolved.
Key takeaways
Immune Reconstitution Inflammatory Syndrome (IRIS) is an exaggerated inflammatory response to a pre-existing opportunistic pathogen or antigen that occurs when the immune system recovers (e.g., rising CD4 counts) following the initiation of ART. It can radiographically mimic worsening infection or miliary disease.
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