An unusual cause of chest pain: Mycobacterium avium complex and the immune reconstitution inflammatory syndrome
Division of Hospital Medicine, Department of Medicine, Weill Cornell Medical College and New York‐Presbyterian Hospital, 525 East 68th Street, Box 130, New York, NY, 10065
The HIV‐associated immune reconstitution inflammatory syndrome usually manifests as new infections or worsening of pre‐existing infections during the first few months of initiating anti‐retroviral therapy. It is commonly associated with local or systemic inflammation, presumably due to rapid reconstitution of host immune system. Here we describe a unique case of the immune reconstitution inflammatory syndrome presenting as acute pericarditis and pericardial effusion caused by mycobacterium avium complex. We also demonstrate that judicious use of steroids, along with pathogen specific antimicrobial therapy, can prevent local complications of the inflammatory response. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.