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

Updated: Jun 12, 2019
  • Author: Robert A Copeland, Jr, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Varicella-zoster virus (VZV) and herpes simplex virus (HSV) are the most common causes of infectious keratitis in HIV-positive patients. Keratitis due to VZV usually is associated with herpes zoster ophthalmicus, with or without the presence of dermatitis. In HIV-infected patients, compared with the general population, VZV and HSV keratitis tend to reoccur more often, and they may be resistant to treatment. [6, 7]

Bacterial and fungal keratitis are not more frequent in HIV patients, but these infections tend to be more severe. The most common organism is Candida, especially in intravenous drug users. Microsporida organisms have also has been implicated. In general, Gram stain and cultures are used to guide treatment. Microsporidia are very difficult to culture, but it is seen readily within corneal or conjunctival epithelial cells with the use of Masson trichrome or Giemsa stain.

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