Pneumocystis carinii infection of the conjunctiva in a patient with acquired immune deficiency syndrome.
BACKGROUND
Ocular disease, especially the development of choroidal lesions, is a known extrapulmonary manifestation of Pneumocystis carinii infection in the acquired immune deficiency syndrome (AIDS). To our knowledge, conjunctival involvement due to P. carinii has not been described previously.


METHODS
The authors describe a 33-year-old homosexual male with AIDS in whom a large placoid, white lesion developed involving the tarsal conjunctiva of the right upper lid. Conjunctival malignancy was suspected and biopsies and swabs were taken. At this time, the patient had been receiving monthly aerosolized pentamidine prophylaxis for 18 months, and there was neither a history of pneumonia nor any clinical signs of disseminated infection due to P. carinii.


RESULTS
Histopathologic examination results of the conjunctival biopsy specimen showed a necrotic, frothy tissue surrounded by activated fibroblasts. Within this material, Gomori methenamine silver stains showed numerous round and cup-like cysts of P. carinii, confirming the diagnosis that had already been obtained by an indirect fluorescent-antibody stain of a conjunctival smear specimen.


CONCLUSIONS
The presence of white placoid conjunctival lesions in a patient with AIDS may indicate an infection due to P. carinii. Conjunctival disease due to P. carinii widens the spectrum of AIDS-associated ophthalmic pneumocystosis.
Ruggli
G M
GM
Department of Ophthalmology, University Hospital of Zürich, Switzerland.
Weber
R
R
Messmer
E P
EP
Font
R L
RL
Moll
C
C
Bernauer
W
W
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003228:Conjunctiva / Q000382:microbiology / Q000473:pathology; D003229:Conjunctival Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D003622:Dapsone / Q000627:therapeutic use; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D011010:Pneumocystis / Q000302:isolation & purification; D016720:Pneumocystis Infections / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D014295:Trimethoprim / Q000627:therapeutic use
D000890:Anti-Infective Agents; D003622:Dapsone; D014295:Trimethoprim