Figure 1.

Upper left: a patient with tuberculosis (TB) who developed persistent and relapsing immune reconstitution inflammatory syndrome (IRIS) in the form of necrotic lymphadenopathy. The patient had undergone several drainages when the photograph was taken. Upper right: a patient who came to the US from Mexico and presented with disseminated histoplasmosis and mycobacterium avium complex (MAC) and exhibited enlarged and inflamed lymph nodes after ART initiation. Bottom left: a patient who had unmasking MAC lymphadenitis that caused necrotic lymphadenopathy that was compressing the trachea and jugular vein. The condition required corticosteroid treatment and lymph node drainage. Bottom right: a patient with miliary TB, TB arthritis, and osteomyelitis who developed severe persistent IRIS that caused blockage of the thoracic duct and chylothorax. Adapted from Hsu et al,¹ and from Barber et al¹⁷