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Herpetic epithelial keratitis caused by acyclovir-resistant strain.
Jpn J Ophthalmol. 1994; 38(4):407-10.JJ

Abstract

Dendritic keratitis occurred during oral acyclovir (ACV) therapy in a 60-year-old man. Corneal stromal edema and iritis were found at his first visit. Herpetic keratouveitis was suspected, based on clinical findings and previous history. Treatment with steroid eyedrops and ACV ointment was initiated. However, ACV [corrected] ointment was changed to oral ACV, since conjunctival ulcer occurred as an adverse effect of the ointment. Subsequently, he received long-term oral ACV medication and steroid eyedrops for recurrent keratitis. The fifth recurrence was also treated with oral ACV and steroid eyedrops. At this time, although the stromal keratitis had improved, there was an outbreak of dendritic keratitis. The lesion healed spontaneously after only a reduction in the steroid. The 50% effective dose (ED)50 of the isolated virus to ACV was 4.4 +/- 0.15 micrograms/ml (mean +/- SD), a level considered ACV-resistant in vitro. The clinical course of this case emphasizes that it is important to consider the route and duration of ACV administration and the use of steroids in the treatment of stromal keratitis or keratouveitis.

Authors+Show Affiliations

Department of Ophthalmology, Osaka University Medical School, Suita, Japan.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

7723210

Citation

Mori, Y, et al. "Herpetic Epithelial Keratitis Caused By Acyclovir-resistant Strain." Japanese Journal of Ophthalmology, vol. 38, no. 4, 1994, pp. 407-10.
Mori Y, Inoue Y, Shimomura Y. Herpetic epithelial keratitis caused by acyclovir-resistant strain. Jpn J Ophthalmol. 1994;38(4):407-10.
Mori, Y., Inoue, Y., & Shimomura, Y. (1994). Herpetic epithelial keratitis caused by acyclovir-resistant strain. Japanese Journal of Ophthalmology, 38(4), 407-10.
Mori Y, Inoue Y, Shimomura Y. Herpetic Epithelial Keratitis Caused By Acyclovir-resistant Strain. Jpn J Ophthalmol. 1994;38(4):407-10. PubMed PMID: 7723210.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Herpetic epithelial keratitis caused by acyclovir-resistant strain. AU - Mori,Y, AU - Inoue,Y, AU - Shimomura,Y, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 407 EP - 10 JF - Japanese journal of ophthalmology JO - Jpn. J. Ophthalmol. VL - 38 IS - 4 N2 - Dendritic keratitis occurred during oral acyclovir (ACV) therapy in a 60-year-old man. Corneal stromal edema and iritis were found at his first visit. Herpetic keratouveitis was suspected, based on clinical findings and previous history. Treatment with steroid eyedrops and ACV ointment was initiated. However, ACV [corrected] ointment was changed to oral ACV, since conjunctival ulcer occurred as an adverse effect of the ointment. Subsequently, he received long-term oral ACV medication and steroid eyedrops for recurrent keratitis. The fifth recurrence was also treated with oral ACV and steroid eyedrops. At this time, although the stromal keratitis had improved, there was an outbreak of dendritic keratitis. The lesion healed spontaneously after only a reduction in the steroid. The 50% effective dose (ED)50 of the isolated virus to ACV was 4.4 +/- 0.15 micrograms/ml (mean +/- SD), a level considered ACV-resistant in vitro. The clinical course of this case emphasizes that it is important to consider the route and duration of ACV administration and the use of steroids in the treatment of stromal keratitis or keratouveitis. SN - 0021-5155 UR - https://www.unboundmedicine.com/medline/citation/7723210/Herpetic_epithelial_keratitis_caused_by_acyclovir_resistant_strain_ L2 - http://www.diseaseinfosearch.org/result/3400 DB - PRIME DP - Unbound Medicine ER -