Background Deep fungal infections have been a major cause of morbidity and mortality in HIV-infected host, gaining importance due to their severity and poor prognosis. Because instituted antiretroviral therapy in patients infected with HIV in the last decade, it is expected that the profile of the deep mycoses in our country has changed, despite the increase in cases of HIV infection registered. The objective of this study was to report the frequency of deep mycosis in a population of HIV-positive patients in Montevideo, Uruguay.

Method The clinical fungal isolates obtained from biological samples, in HIV positive patients, processed in Section Mycology, Laboratory of Pathology University Hospital, between 2008 and 2012. The diagnosis of deep mycoses, was established by conventional mycological study (direct examination and culture). This was complemented by detection of antigen of Cryptococcus spp. in CSF samples, and direct immunofluorescence for Pneumocystis jirovecii in bronchoalveolar-lavage specimens.

Results Of 479 studies in HIV-positive patients, 248 were of cerebrospinal fluid, 83-bronchioloalveolar washes, 42 biopsies, 36 blood, 24 bone marrow, skin 20, and 26 belonged to other locations. 89 samples were found positive, of which 76 were from Cryptococcus spp.; 6 to Histoplasma capsulatum, Pneumocystis jirovecii 6 and 1 to Candida albicans isolated from the peritoneal fluid. Discussion: The frequency of deep mycoses was 18.6% of the samples studied. Cryptococcosis and meningo-encephalic presentation was the most frequent (75% of samples positive for Cryptococcus spp.), histoplasmosis, and pneumocystosis represented 7% each of the total positive samples. The deep mycoses remains so similiar to previous periods in our country, persisting as a real problem in this population. The distribution of etiologic agents remained significantly unchanged as Cryptococcus spp. main exponent, but still keeps a significant decrease in the frequency and Pneumocystis jirovecii, Histoplasma capsulatum, and the absence of cases of aspergillosis.