TABLE 1.

Common clinical manifestations of Immune Reconstitution Inflammatory Syndrome.

Pathogen	Clinical features	Comments
TB	Worsening respiratory complaints Symptoms related to airway compression Pleural effusion (new or progression) Lymphadenitis Central nervous system involvement, including focal signs, seizures and meningism	New central nervous system lesions may be asymptomatic Aspirates from lymph nodes commonly culture-negative
BCG	Inflammatory changes and abscess formation at injection site or draining lymph nodes (axillary and cervical) Rarely, evidence of disseminated disease (e.g. hepatosplenomegaly or osteomyelitis)	Localised disease is generally a clinical diagnosis that seldom requires microbiological confirmation
CMV	Pneumonitis Retinitis	Pneumonitis more common than in adults, but retinitis much less common
NTM (e.g. Mycobacterium avium)	Lymphadenitis Abdominal complaints	Frequently culture-negative with well-formed granulomas on histology

TB, tuberculosis; BCG, Bacille Calmette–Guérin; CMV, cytomegalovirus; NTM, non-tuberculous mycobacteria.