Atypical Herpes simplex keratitis (HSK) presenting as a perforated corneal ulcer with a large infiltrate in a contact lens wearer: multinucleated giant cells in the Giemsa smear offered a clue to the diagnosis.

Abstract:

PURPOSE:To report a case of atypical herpes simplex keratitis initially diagnosed as bacterial keratitis, in a contact lens wearer. RESULTS:Case report of an 18-year-old woman using contact lenses who presented with pain, redness and gradual decrease in vision in the right eye. Examination revealed a paracentral large stromal infiltrate with a central 2-mm perforation. Corneal and conjunctival scrapings were collected for microbiological investigations. Corneal tissue was obtained following penetrating keratoplasty. Corneal scraping revealed no microorganisms. Giemsa stained smear showed multinucleated giant cells. Conjunctival, corneal scrapings and tissue were positive for herpes simplex virus - 1 (HSV) antigen. Corneal tissue was positive for HSV DNA by PCR. CONCLUSIONS:Atypical HSV keratitis can occur in contact lens wearers. A simple investigation like Giemsa stain may offer a clue to the diagnosis.

journal_name

BMC Ophthalmol

journal_title

BMC ophthalmology

authors

Athmanathan S,Pranesh VM,Pasricha G,Garg P,Vemuganti GK,Sharma S

doi

10.1186/1471-2415-1-1

keywords:

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

1

issn

1471-2415

journal_volume

1

pub_type

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