ABSTRACT
More than 90% of patients with HIV infection develop fungal infection during the course of their disease. The most common infection is mucosal candidiasis. Although vaginosis may be increased in patients with AIDS, it does not present as much problem in severity or recurrences as does oropharyngeal candidosis. The latter first appears at modest depressions of immunity, when CD4 counts are in the range of 300 to 400/mm3. As immunity further wanes, both the severity and frequency of recurrence increase. Eventually, when the CD4 falls well below 100/mm3, mucosal infection extends to the esophagus, producing symptoms of substernal pain and dysphagia. Finally, as bone marrow reserves fail, and often under the influences of cytotoxic drugs such as ganciclovir and disruption of the integument by intravenous catheters, hematogenous disseminated disease may occur. In the end stages of AIDS, patients are also susceptible to a variety of other mycoses, including cryptococcosis, histoplasmosis, coccidioidomycosis, and aspergillosis. Together these "other" pathogens may infect between 5% and 10% of AIDS patients (1-9).
