Cotton-Wool Spots HIV — SCE Infectious Diseases MCQ

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ModerateHIV MedicineCotton-Wool Spots HIVSCE Infectious Diseases

A 35-year-old man with HIV (CD4 50) develops bilateral cotton-wool spots on fundoscopy. He has no visual symptoms. What is the management?

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Correct answer: A — Monitor closely with serial fundoscopy every 2–4 weeks — cotton-wool spots at CD4 <50 may represent early CMV retinitis; start ART urgently

Cotton-wool spots in advanced HIV can represent HIV microvasculopathy (benign) or early CMV retinitis. Close monitoring with serial fundoscopy and urgent ART are essential.

Reference: BHIVA 2022 – OI guidelines; AAO 2020