orabase and Acquired-Immunodeficiency-Syndrome

To report three cases of bilateral microbial keratitis in eyes with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) induced by highly active antiretroviral therapy (HAART) in patients of acquired immune deficiency syndrome (AIDS).. A case series.. A detailed clinical examination and systemic review of all the three patients on HAART was performed. While one manifested with the more severe variant of TEN, two of these patients presented with SJS with ocular involvement. Despite withdrawal of nevirapine, the ocular surface disorder persisted. The entailing chronic epitheliopathy along with the compromised immune status led to the development of secondary microbial keratitis in all these cases.. The immune reconstitution occurring as a response to the antiretroviral therapy may potentially increase immunologically mediated diseases like SJS and TEN, which in turn may predispose the eye to develop corneal ulcer.

Topics: Acquired Immunodeficiency Syndrome; Adult; Amnion; Anti-Bacterial Agents; Antiretroviral Therapy, Highly Active; Aza Compounds; Benzamidines; Carboxymethylcellulose Sodium; Cefazolin; Chlorhexidine; Corneal Ulcer; Drug Therapy, Combination; Fluoroquinolones; Humans; Male; Middle Aged; Moxifloxacin; Pain; Quinolines; Stevens-Johnson Syndrome; Tobramycin; Treatment Outcome; Tropanes; Visual Acuity

Topics: Acquired Immunodeficiency Syndrome; Adult; Carboxymethylcellulose Sodium; CD4-CD8 Ratio; CD4-Positive T-Lymphocytes; Humans; Leukocyte Count; Male; Mouth Mucosa; Prednisone; Recurrence; Stomatitis, Aphthous; Triamcinolone

This report describes persistent, painful oral ulcers that occurred in nine patients with the acquired immunodeficiency syndrome (AIDS). These ulcers resembled major aphthous ulcers in clinical appearance and response to therapy. They occurred less frequently in patients with AIDS than those caused by herpes simplex and were found in 4 of 346 (1.1%) patients with AIDS at one medical center. Lesions were typically painful. Identification and treatment with topical tetracycline and steroids led to resolution with relief of symptoms. Further study is necessary to understand the etiology and pathogenesis of these ulcers.

Topics: Acquired Immunodeficiency Syndrome; Carboxymethylcellulose Sodium; Female; Humans; Male; Stomatitis, Aphthous; Tetracycline; Triamcinolone Acetonide