Case Report: Bilateral Herpes Simplex Virus‑ related Peripheral Ulcerative Keratitis Leading to Corneal Perforation in a Patient with Primary Herpes Simplex Virus Infection

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Chranioti Angeliki; Malamas Angelakis; Metallidis Simeon; Mataftsi Asimina; Chalvatzis Nikolaos; Ziakas Nikolaos

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Journal: Journal of Ophthalmic and Vision Research Year:2019 | Volume:14 | Issue:1 Page(s): 93-96

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Title

Case Report: Bilateral Herpes Simplex Virus‑ related Peripheral Ulcerative Keratitis Leading to Corneal Perforation in a Patient with Primary Herpes Simplex Virus Infection

Author(s)

Keywords

Bilateral Corneal Perforation

Herpes Simplex Virus‑

Peripheral Ulcerative Keratitis

HSV‑

1 PUK

Primary HSV Infection

Abstract

Purpose: To present a case of bilateral Peripheral Ulcerative Keratitis (PUK) caused by primary Herpes Simplex Virus‑; 1 (HSV‑; 1) infection resulting in corneal perforation. Case Report: A 24‑ year‑ old man presented at the eye casualty of our clinic, with a 20‑ day history of severe pain, redness, photophobia, and tearing in both of his eyes. Slit‑ lamp examination revealed bilateral superior corneal perforation. A laboratory work‑ up that included immunological testing for infectious and autoimmune factors showed Primary HSV Infection. Positive PCR analysis of corneal scrapings for HSV confirmed initial end‑ organ ocular infection. Because the patient showed progressive HSV‑; 1‑ related PUK resulting in bilateral superior corneal perforation with iris prolapse, he was prescribed both systemic and topical acyclovir and prednisone. He then underwent bilateral surgical intervention, namely eccentric penetrating keratoplasty in one eye and a two step procedure in the other, whereby two corneal patch grafts and an amniotic membrane transplant were initially used, followed 1 month later by a large diameter penetrating keratoplasty. Conclusion: In cases of PUK, differential diagnosis should include infectious and autoimmune diseases. Primary HSV should also be considered as a potential cause of this form of keratitis, which, if left untreated, can lead to devastating outcomes. To our knowledge, this is the first published case of bilateral PUK caused by primary HSV‑; 1 infection.

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APA: Copy

Chranioti, Angeliki, Malamas, Angelakis, Metallidis, Simeon, Mataftsi, Asimina, Chalvatzis, Nikolaos, & Ziakas, Nikolaos. (2019). Case Report: Bilateral Herpes Simplex Virus‑ related Peripheral Ulcerative Keratitis Leading to Corneal Perforation in a Patient with Primary Herpes Simplex Virus Infection. JOURNAL OF OPHTHALMIC AND VISION RESEARCH, 14(1), 93-96. SID. https://sid.ir/paper/311750/en

Vancouver: Copy

Chranioti Angeliki, Malamas Angelakis, Metallidis Simeon, Mataftsi Asimina, Chalvatzis Nikolaos, Ziakas Nikolaos. Case Report: Bilateral Herpes Simplex Virus‑ related Peripheral Ulcerative Keratitis Leading to Corneal Perforation in a Patient with Primary Herpes Simplex Virus Infection. JOURNAL OF OPHTHALMIC AND VISION RESEARCH[Internet]. 2019;14(1):93-96. Available from: https://sid.ir/paper/311750/en

IEEE: Copy

Angeliki Chranioti, Angelakis Malamas, Simeon Metallidis, Asimina Mataftsi, Nikolaos Chalvatzis, and Nikolaos Ziakas, “Case Report: Bilateral Herpes Simplex Virus‑ related Peripheral Ulcerative Keratitis Leading to Corneal Perforation in a Patient with Primary Herpes Simplex Virus Infection,” JOURNAL OF OPHTHALMIC AND VISION RESEARCH, vol. 14, no. 1, pp. 93–96, 2019, [Online]. Available: https://sid.ir/paper/311750/en

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