Resolution of microsporidial keratoconjunctivitis in an AIDS patient treated with highly active antiretroviral therapy.
OBJECTIVE
To report the outcome of microsporidial keratoconjunctivitis in a patient with acquired immunodeficiency syndrome (AIDS) after highly active antiretroviral therapy without any specific treatment for microsporidiosis.


METHODS
Case report. A 42-year-old woman diagnosed with AIDS and severe immunodepression (CD4+ of 9 cells/mm(3) and viral load of 460,000/mm(3)), antiretroviral naive, presented with cerebral toxoplasmosis and microsporidial keratoconjunctivitis in the right eye documented by conjunctival scraping and electron microscopy.


RESULTS
The patient was treated with a combination of indinavir, stavudine, and lamivudine, besides sulfadiazine and pyrimethamine. No specific treatment for the microsporidial keratoconjunctivitis was attempted. One month later, the keratoconjunctivitis had disappeared.


CONCLUSIONS
This case suggests that microsporidial keratoconjunctivitis in the setting of AIDS and severe immunodepression can be effectively managed with highly active antiretroviral therapy alone.
Department of Ophthalmology, Federal University of São Paulo-Paulista School of Medicine, Rua Botucatu 824, São Paulo-SP, Brazil. eyebr@webmail.epm.br
S A
SA
Martins
C
C
Muccioli
R
R
Belfort
A
A
Castelo
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000469:parasitology; D000328:Adult; D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D004359:Drug Therapy, Combination; D015822:Eye Infections, Parasitic / Q000188:drug therapy* / Q000469:parasitology; D005260:Female; D006801:Humans; D019469:Indinavir / Q000627:therapeutic use; D007637:Keratoconjunctivitis / Q000188:drug therapy* / Q000469:parasitology; D019259:Lamivudine / Q000627:therapeutic use; D016814:Microsporidia / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000188:drug therapy* / Q000469:parasitology; D018119:Stavudine / Q000627:therapeutic use; D014792:Visual Acuity
D019380:Anti-HIV Agents; D019259:Lamivudine; D019469:Indinavir; D018119:Stavudine