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Bilateral herpes simplex keratitis presenting as peripheral ulcerative keratitis.
Cornea 2012; 31(5):570-1C

Abstract

PURPOSE

To report a case of bilateral Herpes simplex keratitis (HSK) masquerading as peripheral ulcerative keratitis (PUK).

METHODS

A case of a 47-year-old female complaining of painful red eyes with a history of arthritis and anterior uveitis attacks with positive antinuclear antibodies (ANA). Biomicroscopy revealed PUK, stromal infiltrations and bilateral central corneal epithelial erosions. Slit-lamp examination disclosed +3 anterior chamber cells in both eyes.

RESULTS

Blood testing was positive for ANA. Herpes simplex virus (HSV) antigen was identified in both eyes using polymerase chain reaction (PCR). The management included topical prednisolone and acyclovir, as well as systemic valacyclovir. Improvement of epithelial corneal defects, PUK, and visual acuity was achieved gradually during the follow-up period.

CONCLUSIONS

Bilateral herpetic keratitis presenting as PUK is an extremely rare manifestation of herpetic disease. PUK can pose a diagnostic dilemma in cases with immune system dysregulation. Excluding infectious agents is mandatory for appropriate treatment.

Authors+Show Affiliations

Department of Ophthalmology, Aristotle University, Thessaloniki, Greece. praidou2003@yahoo.co.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22378116

Citation

Praidou, Anna, et al. "Bilateral Herpes Simplex Keratitis Presenting as Peripheral Ulcerative Keratitis." Cornea, vol. 31, no. 5, 2012, pp. 570-1.
Praidou A, Androudi S, Kanonidou E, et al. Bilateral herpes simplex keratitis presenting as peripheral ulcerative keratitis. Cornea. 2012;31(5):570-1.
Praidou, A., Androudi, S., Kanonidou, E., Konidaris, V., Alexandridis, A., & Brazitikos, P. (2012). Bilateral herpes simplex keratitis presenting as peripheral ulcerative keratitis. Cornea, 31(5), pp. 570-1. doi:10.1097/ICO.0b013e31822f3c18.
Praidou A, et al. Bilateral Herpes Simplex Keratitis Presenting as Peripheral Ulcerative Keratitis. Cornea. 2012;31(5):570-1. PubMed PMID: 22378116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral herpes simplex keratitis presenting as peripheral ulcerative keratitis. AU - Praidou,Anna, AU - Androudi,Sofia, AU - Kanonidou,Evgenia, AU - Konidaris,Vassilios, AU - Alexandridis,Alexandros, AU - Brazitikos,Periklis, PY - 2012/3/2/entrez PY - 2012/3/2/pubmed PY - 2012/6/8/medline SP - 570 EP - 1 JF - Cornea JO - Cornea VL - 31 IS - 5 N2 - PURPOSE: To report a case of bilateral Herpes simplex keratitis (HSK) masquerading as peripheral ulcerative keratitis (PUK). METHODS: A case of a 47-year-old female complaining of painful red eyes with a history of arthritis and anterior uveitis attacks with positive antinuclear antibodies (ANA). Biomicroscopy revealed PUK, stromal infiltrations and bilateral central corneal epithelial erosions. Slit-lamp examination disclosed +3 anterior chamber cells in both eyes. RESULTS: Blood testing was positive for ANA. Herpes simplex virus (HSV) antigen was identified in both eyes using polymerase chain reaction (PCR). The management included topical prednisolone and acyclovir, as well as systemic valacyclovir. Improvement of epithelial corneal defects, PUK, and visual acuity was achieved gradually during the follow-up period. CONCLUSIONS: Bilateral herpetic keratitis presenting as PUK is an extremely rare manifestation of herpetic disease. PUK can pose a diagnostic dilemma in cases with immune system dysregulation. Excluding infectious agents is mandatory for appropriate treatment. SN - 1536-4798 UR - https://www.unboundmedicine.com/medline/citation/22378116/Bilateral_herpes_simplex_keratitis_presenting_as_peripheral_ulcerative_keratitis_ L2 - http://Insights.ovid.com/pubmed?pmid=22378116 DB - PRIME DP - Unbound Medicine ER -