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Diagnosis and Management of Tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS)

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D Optimal management at this point consists of continuing antiretroviral medications and TB therapy without change, obtaining sputum cultures to rule out drug-resistant TB, and administering corticosteroids if his clinical condition deteriorates further.

This answer is correct. This patient's history and chest radiographic findings are most consistent with TB immune reconstitution inflammatory syndrome. Management of this complication typically involves continuing antiretroviral therapy, maintaining the planned course of anti-TB therapy, and adding corticosteroids if needed for moderate or severe disease.

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