Fungal Keratitis and Ocular Surface Squamous Neoplasia in a HIV Positive Patient

Ramya Marappa,Thanuja Pradeep

doi:10.4236/ojoph.2016.62015

Abstract

Aim: We report a case of fungal keratitis and Ocular Surface Squalous Neoplasia (OSSN) occurring in a HIV positive patient. Method: A 32-year-old female patient presented with a non-healing ulcer, which was diagnosed as fungal keratitis. On examination her ocular surface also revealed OSSN on the nasal bulbar conjunctiva. Serological investigations revealed HIV positive status with CD 4 counts of 61 cells/μl. Patient was treated for fungal keratitis with topical antifungals and also underwent excision biopsy of OSSN which was reported as conjunctival intraepithelial neoplasia. The ulcer showed significant response to topical medication only after the commencement of Anti-Retroviral Therapy (ART). Conclusion: This case emphasizes on the importance of a thorough ocular examination to rule out associated ocular conditions and investigations to rule out immunosuppressive status in a non-healing ulcer.

Highlights

Immunosuppressed conditions associated with Ocular Surface Squamous Neoplasia (OSSN) has been emphasized in many previous publications especially in young individuals [1]-[3]
We present a case of a young patient presenting with both fungal keratitis and OSSN
To our knowledge a combined presentation has not been reported earlier in literature. This case reiterates the importance of complete ocular examination and the need to investigate for immunosuppression in cases of non-healing ulcers and OSSN, especially in young individuals

Summary

Introduction

Immunosuppressed conditions associated with Ocular Surface Squamous Neoplasia (OSSN) has been emphasized in many previous publications especially in young individuals [1]-[3]. How to cite this paper: Pradeep, T. and Marappa, R. (2016) Fungal Keratitis and Ocular Surface Squamous Neoplasia in a HIV Positive Patient. Fungal keratitis has been reported to occur at increased frequency in retroviral positive patients [4]. We present a case of a young patient presenting with both fungal keratitis and OSSN. To our knowledge a combined presentation has not been reported earlier in literature. This case reiterates the importance of complete ocular examination and the need to investigate for immunosuppression in cases of non-healing ulcers and OSSN, especially in young individuals

Case Report

Discussion

Findings

Conclusion