The commonest clinical manifestations of TB-IRIS are fever, lymphadenopathy and worsening respiratory symptoms [47] . Pulmonary disorders, such as new pulmonary infiltrates, mediastinal lymphadenopathy, and pleural effusions are also common [7] . Extrapulmonary presentations are also possible, including disseminated tuberculosis with associated acute renal failure [6] , systemic inflammatory responses (SIRS) [48] , and intracranial tuberculomas [45] . Pulmonary TB-IRIS can be diagnosed by transient worsening of chest radiographs, especially if old radiographs are available for comparison. Other symptoms are nonspecific, and include persistent fever, weight loss, and worsening respiratory symptoms. Abdominal TB-IRIS can present with nonspecific abdominal pain and obstructive jaundice.