Unmasking immune reconstitution inflammatory syndrome [IRIS] A report of five cases and review of the literature

Immune reconstitution inflammatory syndromes [IRIS] in patients with acquired immune deficiency syndrome [AIDS] are characterised by atypical manifestations of opportunistic pathogens. These occur in patients experiencing improvement in CD4 cell counts following receipt of highly active anti-retroviral therapy [HAART]. Although well established as a syndrome, IRIS still presents challenges in diagnosis and management. We report five cases of IRIS with diverse clinical presentations and due to different infectious aetiologies. A review of the published literature on this syndrome is also included

Case of neurosyphilis presented as recurrent stroke

A 46 year old male patient was presented with a history of hypertension, diabetes mellitus and coronary artery disease was reported to have had a cerebrovascular accident of which features were suggestive of a new and rapidly progressive stroke. Upon investigation for recurrent stroke, the patient was found to have a positive serology for Syphilis. The possibility of neruosyphilis was considered, which was later confirmed by positive serology in the cerebrospinal fluid. The case is lenghly discussed in this report to emphasize the presence of syphilis in the 21st century, and to ascertain its importance as an etiological agent in cases of recurrent stroke