Background

Ocular involvement in AIDS patients is a common event mainly caused by inflammation or infection. Despite the high prevalence rate of cryptococcosis in these individuals, ocular features have been occasionally described.

Case report

A 20-year-old Brazilian female with HIV infection recently diagnosed was admitted with a respiratory profile presumptively diagnosed as Pneumocystis jirovecii pneumonia; an ophthalmologic exam suggested choroiditis by this agent as well. She was complaining of headaches and blurred vision which led to cryptococcal meningitis diagnosis by a CSF positive India ink stain and Cryptococcus neoformans positive culture. Despite therapy based on amphotericin B plus fluconazole, her clinical state progressively worsened and the patient died one week later. At necropsy, disseminated cryptococcal infection was evidenced in several organs including eyes, which presented bilateral chorioretinitis.

Conclusions

Cryptococcal ocular involvement in AIDS patients has been occasionally proved among the cases already reported. Thus, the post mortem exam is still pivotal to improve the quality of the clinical diagnosis, especially in limited-resource settings.

中文翻译：

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艾滋病毒感染的散发性隐球菌感染患者的脉络膜炎：病例报告和文献复习。

背景

艾滋病患者的眼部受累是常见事件，主要由炎症或感染引起。尽管在这些个体中隐球菌病的患病率很高，但偶尔会描述眼部功能。

案例报告

一名最近被确诊为HIV感染的20岁巴西女性入院，其呼吸系统特征被认为是吉氏肺孢子虫肺炎。眼科检查也建议使用该药物治疗脉络膜炎。她抱怨头痛和视力模糊，导致脑脊液阳性印度墨水染色和新型隐球菌阳性培养物对隐球菌脑膜炎的诊断。尽管基于两性霉素B加氟康唑的治疗，她的临床状态逐渐恶化，患者在一周后死亡。尸检时，在包括双侧脉络膜视网膜炎的眼睛在内的多个器官中发现了弥散性隐球菌感染。

结论

在已报道的病例中，偶而证明了艾滋病患者的隐球菌眼部感染。因此，验后检查对于提高临床诊断的质量仍然至关重要，特别是在资源有限的情况下。