What is the role of fungal keratitis in the ocular manifestations of HIV infection?

Updated: Jul 21, 2021
  • Author: Luca Rosignoli, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Candidal species are the most common fungal organisms causing keratitis in HIV-positive patients, especially in intravenous drug users. Other fungal organisms known to cause keratitis include Fusarium and Aspergillus species.

Immunosuppression predisposes HIV-positive patients to fungal infections. The nonfilamentous fungi (eg, Candida species) are very common in compromised eyes, particularly with immunosuppression. The filamentous fungi (eg, Fusarium or Aspergillus species) are seen in association with trauma with vegetable matter.

In some developing countries, fungal keratitis may be an indicator of HIV infection. In a study from Africa, 26 of 32 (81.2%) patients with fungal keratitis were found to be HIV positive; 60 of 180 (33%) of those with nonfungal keratitis were HIV positive. Fusarium solani was the most common organism, accounting for 75% of cases with fungal keratitis. [8]

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