Scabies Exacerbation With Eosinophilia As Immune Reconstitution Inflammatory Syndrome in a Patient With AIDS and Pneumocystis Pneumonia: A Case Report

Only a few studies have reported the relationship between immune reconstitution inflammatory syndrome (IRIS) and scabies. A 30-year-old homosexual man who lived in a dorm was diagnosed with AIDS based on his CD4 count: 10/μL, HIV-1 real-time PCR: 100000 copies/mL, and pneumocystis pneumonia (PCP). Although he developed a rash on his face and back shortly before, it exacerbated rapidly, and a rise of eosinophils was noted in his blood after initiation of antiretroviral therapy. Initially, he was suspected of having IRIS of PCP with eosinophilia, but he was ultimately diagnosed with scabies, which was thought to be exacerbated by IRIS. He recovered completely from his symptoms and eosinophilia after combination therapy of ivermectin and sulfur formulations.