Immune reconstitution inflammatory syndrome in an HIV-infected patient with disseminated coccidioidomycosis

Immune reconstitution inflammatory syndrome (IRIS) is a condition characterized by excessive inflammatory response to an underlying pathogen following immune recovery. IRIS associated with coccidioidomycosis infection is rare, with only a few cases reported to date. Unfortunately, the mortality rate for disseminated coccidioidomycosis-related IRIS in the available literature is extremely high. We present a case of paradoxical IRIS associated with disseminated coccidioidomycosis in an HIV-infected patient following initiation of antiretroviral therapy, who was successfully treated with steroid therapy.