ArticleIDCases2025
An atypical presentation of immune reconstitution inflammatory syndrome (IRIS) in a patient with cryptococcal meningitis in the setting of fingolimod therapy for multiple sclerosis.
Article in IDCases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Fungal Infections Associated with Sphingosine 1-Phosphate Receptor Modulators: Immunological Mechanisms, Clinical Patterns, and Management Considerations.Microorganisms · 2026Review
- Corticosteroids as adjunctive therapy in acute meningitis: a narrative review.Annals of medicine and surgery (2012) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Central nervous system (CNS) cryptococcosis in the setting of fingolimod therapy for multiple sclerosis is an increasingly recognised, and often fatal entity. Furthermore, some patients may develop immune reconstitution inflammatory syndrome (IRIS) after the initiation of anti-fungal therapy and cessation of fingolimod. Clinical and radiological progression despite appropriate antifungal treatment often leads to a therapeutic dilemma of whether to use corticosteroids if IRIS is suspected. We present a case of a patient with CNS IRIS that responded to oral prednisolone treatment, in the setting of CNS cryptococcal infection and background fingolimod therapy. Interestingly, our patient had a normal CD4 and total peripheral lymphocyte count. This case serves as a reminder that a high index of suspicion is needed when patients who are being treated with fingolimod, present with subtle symptoms and signs of meningitis, and, additionally, it provides further evidence that IRIS in HIV negative patients, may respond to corticosteroid treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.