免疫重建炎症综合征（IRIS）是指，由于一系列促炎性反应，在长期白细胞减少之后免疫功能逐渐恢复，导致潜在或慢性感染症状加重的情况。在接受急性淋巴细胞白血病（ALL）化疗的孩子中，可能会发生这种情况，尤其是对于患有慢性播散性念珠菌感染（CDC）的患儿。我们报道了一位7岁的女孩，患有前B型ALL，正在接受化疗，长期发热性中性粒细胞减少，患有CDC，在肝脏、脾脏和肾脏中有微小脓肿，并在重症监护室停留了较长时间。在中性粒细胞恢复后，她持续高烧（血液和尿液培养阴性）。她的双侧股部肌肉出现严重肌炎，并在下背部和右侧大腿的皮下组织中形成了异常的肉芽肿。虽然怀疑发生了IRIS，但由于多重耐药阿鲁氏不动杆菌引起的右上肺叶塌陷性肺实变，无法开始使用激素治疗，而该菌株后来被敏感性抗生素治疗。激素治疗使患者的发热消失并恢复了炎症标志物的正常水平。目前她正在进行化疗维持治疗，并状况良好。IRIS可能会加重儿童ALL的治疗情况。在同时存在细菌感染的情况下诊断它是具有挑战性的。很少会出现CDC引起皮下肉芽肿的情况。在合适的时间使用激素治疗非常重要。版权所有©2023 Wolters Kluwer Health，Inc. 保留所有权利。

Immune reconstitution inflammatory syndrome (IRIS) occurs when there is immune recovery after a prolonged period of leucopenia as a response to an underlying latent or chronic infection due to a proinflammatory cascade. It can occur in a child on chemotherapy for acute lymphoblastic leukemia (ALL) with underlying chronic disseminated candidiasis (CDC).We present a 7-year-old girl with pre-B ALL on chemotherapy who had prolonged febrile neutropenia and CDC with microabscesses in the liver, spleen, and kidney and a prolonged intensive care unit stay. Upon neutrophil recovery, she continued to have high-grade fever (blood and urine cultures negative). She also presented severe myositis of bilateral thigh muscles and developed unusual granulomas in the subcutaneous region of the lower back and right thigh. Although IRIS was suspected, she could not be initiated on steroids due to right upper lobe collapse consolidation due to multidrug-resistant Acinetobacter baumanni, which was treated with sensitive antibiotics. Treatment with steroids resolved her fever and normalized inflammatory markers. She is currently well on maintenance chemotherapy.IRIS can complicate the treatment of ALL in children. Diagnosing it while having a concurrent bacterial infection is challenging. Rarely CDC can present with subcutaneous granulomas. Treatment with steroids at the right time is very crucial.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.