CD4 and Pleural effusion: Inability to sustain CD4 counts above 200 cells/μL and TB-IRIS manifesting with abdominal distention from peritoneal ascites, innumerable lung nodules, and bilateral pleural effusions, yet with improvement in the size of the pancreatic mass and lymphadenopathy in the setting of negative respiratory, gastric, and ascitic microbiologic results for TB, argue against treatment failure and development of multidrug resistance [11, 19].