Conjunctival herpetic ulcer in an immunosuppressed patient with birdshot chorioretinopathy Case report

Main Article Content

Ana Fernández-Hortelano
Elena Guzman-Almagro
María Castro-Rebollo
Carlos Izquierdo-Rodríguez
Julio González Martin-Moro

Abstract

Introduction: Herpes Simplex Virus (HSV) is a human herpesvirus responsible for systemic infections. Ocular involvement spans all ocular tissues. Corneal lesions, such as dendritic or geographic ulcers, are frequently found in HSV keratitis while conjunctival lesions have been described as infrequent.


Clinical case: A 62-year-old man diagnosed with Birdshot chorioretinopathy presented a stye in his eyelid that was treated with oxytetracycline-hydrocortisone ointment. One week later he returned presenting several small dendritic corneal ulcers in both eyes and a conjunctival ulcer in one of them. All lesions healed completely after treatment with topical acyclovir ophthalmic ointment at 3%.


Conclusions: We should pay attention to the conjunctiva and not merely focus on the cornea when examining patients with herpetic eye disease, especially if being treated with inmunosupressors.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Fernández-Hortelano A, Guzman-Almagro E, Castro-Rebollo M, Izquierdo-Rodríguez C, González Martin-Moro J. Conjunctival herpetic ulcer in an immunosuppressed patient with birdshot chorioretinopathy. Ophthatherapy [Internet]. 2021Aug.27 [cited 2024Dec.22];8(3):175-8. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/1359
Section
Conservative treatment

References

1. Valerio GS et al. Ocular manifestations of herpes simplex virus. Curr Opin Ophthalmol 2019, 30:525-531.
2. Laibson PR. Current therapy of herpes simplex virus infection of the cornea. Int Ophthalmol Clin 1973; 13: 39-52.
3. Holland EJ, Fingeret M, Mah FS. Use of topical steroids in conjunctivitis: a review of the evidence. Cornea 2019; 38: 1062-1067.
4. American Academy of Ophthalmology Cornea/External disease preferred practice pattern. Panel. Preferred practice pattern Guidelines: Conjunctivitis 2019. Available at: https://www.aao.org/preferredpractice-pattern/conjunctivitis-ppp-2018. Accessed december 12, 2018.
5. Shtein RM, Stahl RM, Saxe SJ et al. Herpes simplex keratitis after intravitreal triamcinolone acetonide. Cornea 2007; 26: 641-642.
6. Kline LB, Jackson B. Herpes Zoster Conjunctival Ulceration. Canad. J. Ophthalmol 1977; 12: 66-67.
7. Zaher SS, Sandinha T, Roberts F et al. Herpes simplex keratitis misdiagnosed as rheumatoid arthritis-related peripheral ulcerative keratitis. Cornea 2005; 24: 1015-1017.
8. Sridhar U, Bansal Y, Choudhury S et al. Conjunctival dendrite in a case of primary herpes simplex infection. Br J Ophthalmol 2004; 88: 590-591.
9. Swaroop R. Conjunctival geographic ulcer and blepharitis in primary ocular herpes: a case report. Cases Journal 2009; 2: 8141.
10. Hung JH, Chu CY, Lee CN et al. Conjunctival geographic ulcer: an overlooked sign of herpes simplex virus infection. J Clin Virol 2015; 64: 40-44.