       Document 0776
 DOCN  M9640776
 TI    Topical fumagillin in the treatment of microsporidial
       keratoconjunctivitis in AIDS.
 DT    9604
 AU    Garvey MJ; Ambrose PG; Ulmer JL; University of California, Davis Medical
       Center, Sacramento 95817,; USA.
 SO    Ann Pharmacother. 1995 Sep;29(9):872-4. Unique Identifier : AIDSLINE
       MED/96087306
 AB    OBJECTIVE: To report microsporidial keratoconjunctivitis in a patient
       infected with HIV who was treated with topical fumagillin. CASE SUMMARY:
       A 37-year-old white man who was experiencing redness, pain, irritation,
       decreased vision, and a foreign body sensation occurring in both eyes
       was referred to the ophthalmology clinic. The patient had a medical
       history significant for AIDS, Pneumocystis carinii pneumonia, and
       Cytomegalovirus retinitis. Conjunctival smears were taken and stained
       positive for the presence of Microsporidia. The patient was diagnosed
       with bilateral microsporidial keratoconjunctivitis and fumagillin
       therapy was initiated. After 5 days of therapy, the patient reported
       significant improvements characterized by a decrease in blurred vision
       with only slight blurring in the left eye, decrease in headache, and
       decreased foreign body sensation. The patient continued topical
       fumagillin therapy for more than 14 months, with only slight blurring in
       the left eye and no apparent ocular toxicity as a result of fumagillin
       therapy. DISCUSSION: Although rare in occurrence, increasing numbers of
       documented microsporidial infections are being reported in the medical
       literature, particularly in individuals who are seropositive for HIV.
       Clinicians need to be cognizant of microsporidial keratoconjunctivitis
       as another opportunistic infection in this patient population.
       CONCLUSIONS: Although a curative agent has yet to be discovered,
       fumagillin represents a safe, effective, low-cost, topical agent for the
       treatment of microsporidial keratoconjunctivitis.
 DE    Administration, Topical  Adult  Animal  Antiprotozoal Agents/ADVERSE
       EFFECTS/*THERAPEUTIC USE  AIDS-Related Opportunistic Infections/*DRUG
       THERAPY/PARASITOLOGY  Case Report  *Encephalitozoon
       Encephalitozoonosis/*DRUG THERAPY/PARASITOLOGY  Fatty Acids,
       Unsaturated/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE  Human
       Keratoconjunctivitis, Infectious/*DRUG THERAPY/PARASITOLOGY  Male
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

