trimethoprim--sulfamethoxazole-drug-combination and Eye-Infections--Fungal

We studied 21 patients with the acquired immunodeficiency syndrome and presumed Pneumocystic carinii choroidopathy. The lesions were characteristically yellow to pale yellow in color, appeared at the level of the choroid, and were found in the posterior pole. They varied in size from 300 to 3,000 microns, initially increasing in number before treatment and eventually resolving after systemic antimicrobial therapy. Of the 21 patients, 18 (86%) had received inhaled pentamidine as prophylaxis against Pneumocystis pneumonia. Visual acuity and visual field testing showed little evidence of retinal destruction. Survival after the diagnosis of the choroidopathy ranged from two to 36 weeks. Pneumocystic choroidopathy offers an easily accessible clue to disseminated Pneumocystis infection. When comparing drugs for Pneumocystis prophylaxis, careful ocular examination can provide one indicator of the relative efficacy of protection against extrapulmonary disease.

Topics: Acquired Immunodeficiency Syndrome; Adult; Choroid Diseases; Drug Administration Routes; Eye Infections, Fungal; Female; Fluorescein Angiography; Fundus Oculi; Humans; Male; Middle Aged; Pentamidine; Pneumocystis; Pneumonia, Pneumocystis; Prognosis; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity; Visual Fields

Topics: Acute Disease; AIDS-Related Opportunistic Infections; Anti-Infective Agents; CD4 Lymphocyte Count; Combined Modality Therapy; Dacryocystitis; Dacryocystorhinostomy; Eye Infections, Fungal; Fatal Outcome; Female; Fluorescent Antibody Technique, Direct; HIV-1; Humans; Lacrimal Apparatus; Paracoccidioides; Paracoccidioidomycosis; Radiography; RNA; Trimethoprim, Sulfamethoxazole Drug Combination; Viral Load; Young Adult

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-Infective Agents; Eye Infections, Fungal; Fluorescein Angiography; Humans; Male; Pneumonia, Pneumocystis; Retinal Vein Occlusion; Trimethoprim, Sulfamethoxazole Drug Combination

To describe an atypical case of central nervous system and ocular paracoccidioidomycoses simulating ocular toxoplasmosis in a pregnant woman with acquired immunodeficiency syndrome (AIDS).. Interventional case report.. Case report.. A 25-year-old pregnant woman with AIDS, presented with a severe ocular inflammation in the right eye involving the choroid, retina, and the optic disk, which rapidly progressed to retinal detachment, iris neovascularization, and neovascular glaucoma. The left eye was normal. Magnetic resonance imaging (MRI) showed a focal hypodense contrast-enhanced ring lesion in the brain. Serum antibody titers were negative for Toxoplasma gondii, but the polymerase chain reaction was positive for the parasite in the vitreous sample. The patient responded partially to specific treatment for toxoplasmosis, and there was a small reduction in size of the brain lesion. She progressed to a blind painful eye, which was enucleated. Paracoccidioides brasiliensis was found in the histopathological studies of the eye and oropharynx. With the diagnosis of disseminated ocular paracoccidioidomycoses, the patient was treated with trimethoprim-sulfamethoxazole with a satisfactory outcome and reduction in size of the brain lesion.. Although ocular infection with ocular paracoccidioidomycoses is rare, this diagnosis should be considered when investigating ocular inflammation in a patient with AIDS.

Topics: Acquired Immunodeficiency Syndrome; Adult; Anti-Infective Agents; Brain Diseases; Eye Enucleation; Eye Infections, Fungal; Female; Humans; Magnetic Resonance Imaging; Paracoccidioides; Paracoccidioidomycosis; Pregnancy; Pregnancy Complications, Infectious; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adult; Amikacin; Cataract; Cataract Extraction; Ceftriaxone; Drug Therapy, Combination; Eye Infections, Fungal; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Nocardia Infections; Postoperative Complications; Transplantation, Homologous; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adult; Aerosols; AIDS-Related Opportunistic Infections; Choroiditis; Eye Infections, Fungal; Humans; Male; Pentamidine; Pneumocystis Infections; Premedication; Trimethoprim, Sulfamethoxazole Drug Combination