PNEUMOCYSTIS-CARINII INFECTION OF THE CONJUNCTIVA IN A PATIENT WITH ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME

Background: Ocular disease, especially the development of choroidal le sions, is a known extrapulmonary manifestation of Pneumocystis carinii infection in the acquired immune deficiency syndrome (AIDS:), To our knowledge, conjunctival involvement due to P. carinii has not been des cribed previously, Methods: The authors describe a 33-year-old homosex ual male with AIDS in whom a large placoid, white lesion developed inv olving the tarsal conjunctiva of the right upper lid, Conjunctival mal ignancy was suspected and biopsies and swabs were taken, At this time, the patient had been receiving monthly aerosolized pentamidine prophy laxis for 18 months, and there was neither a history of pneumonia nor any clinical signs of disseminated infection due to P. carinii. Result s: Histopathologic examination results of the conjunctival biopsy spec imen showed a necrotic, frothy tissue surrounded by activated fibrobla sts. Within this material, Gomori methenamine silver stains showed num erous round and cup-like cysts of P. carinii, confirming the diagnosis that had already been obtained by an indirect fluorescent-antibody st ain of a conjunctival smear specimen, Conclusions: The presence of whi te placoid conjunctival lesions in a patient with AIDS may indicate an infection due to P. carinii Conjunctival disease due to P. carinii wi dens the spectrum of AIDS-associated ophthalmic pneumocystosis.