Successful treatment of immune reconstitution inflammatory syndrome in Whipple's disease using thalidomide

A patient with classic Whipple's disease developed erythema nodosum leprosum-like lesions and fever one month after the beginning of an accurate therapy with trimethoprimsulfamethoxazole. Immune reconstitution inflammatory syndrome was suspected, but corticosteroid therapy failed to improve the patient. Finally, thalidomide was used and successfully induced rapid improvement. (C) 2009 The British Infection Society. Published by Elsevier Ltd. All rights reserved.