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Figure 4 Paradoxical immune reconstitution inflammatory syndrome

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1 Figure 4 Paradoxical immune reconstitution inflammatory syndrome
Figure 4 | Paradoxical immune reconstitution inflammatory syndrome. This representative series of MRI scans depicts a case of paradoxical immune reconstitution inflammatory syndrome (IRIS) attributed to toxoplasmosis-associated encephalitis in an HIV-negative immunocompromised patient with lymphopenia who underwent allogeneic stem cell transplantation. a | Post-gadolinium fluid-attenuated inversion recovery (FLAIR) MRI sequence. b | Pre-gadolinium T1-weighted MRI sequence. c | Post-gadolinium T1-weighted sequence. The MRI sequences depicted here show numerous foci of FLAIR hyperintensity and gadolinium enhancement in the cortex, left thalamus and parietal–occipital regions, indicating toxoplasmosis-associated lesions (white). Perilesional enhancement and oedema are particularly prominent on T2-FLAIR MRI (part a) and surround the left thalamic, right temporal, left frontal and left parietal–occipital lesions. Haemorrhage into the large left basal ganglia lesion can be seen on the pre-contrast T1 image (part b). Bowen, L. N. et al. (2016) HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment Nat. Rev. Neurol. doi: /nrneurol

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