ABSTRACT
PURPOSE: To report treatment of a patient with acquired immunodeficiency syndrome (AIDS) and ocular and paranasal sinus microsporidial infection. METHOD: Case report. RESULTS: A patient with AIDS and ocular microsporidial infection experienced resolution of ocular symptoms with topical fumagillin, but symptoms recurred upon cessation of therapy. Paranasal sinus microsporidial infection was diagnosed. The patient received sequential systemic treatment with itraconazole followed by albendazole. Sinus symptoms resolved with albendazole. He remained symptom-free with a normal examination 17 months after concluding therapy. CONCLUSIONS: Although fumagillin and itraconazole may have played a role, systemic albendazole appears to be responsible for clinical resolution of microsporidial infection.
Subject(s)
Albendazole/therapeutic use , Anthelmintics/therapeutic use , Eye Diseases/parasitology , Microsporida , Paranasal Sinus Diseases/parasitology , Protozoan Infections/drug therapy , Sinusitis/parasitology , Animals , Female , Humans , Male , Middle Aged , Paranasal Sinus Diseases/diagnostic imaging , Radiography , Sinusitis/diagnostic imagingABSTRACT
AIDS: Eye problems are a significant concern for HIV-positive patients, in whom CMV blindness and vision loss is a devastating side effect. CMV retinitis is the most common eye disease in people with HIV, affecting up to 45 percent of people with AIDS. CMV retinitis is treated with oral or intravenous ganciclovir, although some patients have difficulty absorbing the drug, and an eye implant has been developed. Foscarnet is also used in combination therapy. The Food and Drug Administration (FDA) recommends beginning prophylaxis when CD4 counts drop below 50.^ieng
