PMC10164251_01
Timeline of events, investigations, and clinical decisions in a kidney transplant recipient who developed cryptococcal-immune reconstitution inflammatory syndrome.. Note. CT = computed tomography; PCR = polymerase chain reaction; WBC = white blood cells; MRI = magnetic resonance imaging; ICU = intensive care unit; C-IRIS = cryptococcal-immune reconstitution inflammatory syndrome; EBV = Epstein-Barr virus.
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Figure 1 and Table 1 presents a detailed clinical and laboratory timeline.
(A) Selected axial MRI head T2 (top left) and equivalent diffusion-weighted images (top right) showing acute posterior circulation infarcts affecting the thalamus and brainstem. (B) Chest X-ray showing a left lower lobe infiltrate (bottom).
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A septic workup was non-diagnostic except for an opacity in the left lower lobe (Figure 2), concerning for pneumonia. MRI revealed multiple acute end-vessel infarcts involving both thalami (Figure 2, top), pons (Figure 2, middle), midbrain, and left temporal uncus.