Cases reported "Keratitis, Dendritic"

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1/8. Topical tacrolimus ointment for treatment of refractory anterior segment inflammatory disorders.

    PURPOSE: To report 4 cases of patients treated with topical tacrolimus ointment 0.03% for ocular inflammatory conditions refractory to traditional treatment. methods: Four patients were treated topically with tacrolimus 0.03% ointment twice daily: 2 patients with blepharokeratoconjunctivitis, 1 patient with severe atopic keratoconjunctivitis, and 1 patient with chronic follicular conjunctivitis. RESULTS: Three patients had a dramatic improvement of their ocular condition as early as 2 weeks after starting tacrolimus ointment. One patient developed a herpes simplex virus dendrite after 1 week of tacrolimus use. CONCLUSION: tacrolimus ointment appears to be an effective alternative for certain ocular inflammatory conditions refractory to traditional treatments. There may be an increased risk of herpes simplex virus keratitis associated with topical use. Our results support previous literature of patients benefiting from topical tacrolimus use.
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keywords = keratoconjunctivitis
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2/8. Acute ocular infection by type 2 herpes simplex virus in adults.

    Acute ocular infections in two adults were caused by type 2 herpes simplex virus (HSV) ("genital herpesvirus"). One patient had an acute blepharoconjunctivitis, the other an acute keratoconjunctivitis. Genital infections had preceded the eye infections, and type 2 HSV was isolated from the eyes of both patients and from the genital lesions of one patient. This strongly suggests transmission of type 2 HSV from the genital site to the eye.
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keywords = keratoconjunctivitis
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3/8. Oculogenital transmission of type 2 herpes simplex virus in adults.

    Type 2 (genital) herpes simplex virus (HSV-2) was isolated from three patients (two adults and an 11-year-old girl) with acute ocular infections. Two of these patients had acute blepharoconjunctivitis and one had acute keratoconjunctivitis. Genital herpes infections had preceded the eye infections in the two adults. This was not the case in the 11-year-old, but she had been in close contact with her sister who had apparently had the genital disease. The study strongly suggests transmission of HSV-2 from the genital site to the eye.
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keywords = keratoconjunctivitis
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4/8. Treatment of ocular disease in eczema herpeticum.

    Individuals with atopic dermatitis are particularly susceptible to herpes simplex viral infection and may develop dissemination (eczema herpeticum). Additionally, they may develop severe and bilateral herpetic ocular disease. The keratitis is commonly complicated by stromal scarring and slow epithelial healing despite topical antiviral therapy. We treated three patients who had herpetic keratoconjunctivitis associated with eczema herpeticum. In all three cases the keratitis resolved promptly (48 to 72 hours) without residual scarring after treatment with systemic acyclovir and topical trifluridine. The combined use of systemic acyclovir and topical trifluridine may be of similar value in treating all cases of atopic herpetic keratitis.
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keywords = keratoconjunctivitis
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5/8. herpes simplex keratitis in patients with acquired immune deficiency syndrome.

    Acquired immune deficiency syndrome (AIDS) is associated with a wide spectrum of systemic and ocular infectious diseases. Little information is known about herpes simplex virus type 1 (HSV-1) keratoconjunctivitis in association with AIDS. The authors present six cases of recurrent HSV keratitis occurring in AIDS patients. Features of the herpetic keratitis in these patients included unilateral dendritic or geographic epithelial keratopathy; predilection for peripheral versus central corneal involvement; one to three recurrences per patient over a mean observation period of 17 months, with a median dendrite-free interval of 7 months; and a moderately prolonged clinical course with a median healing time of 3 weeks using topical antiviral therapy. Only one of six cases had stromal infiltrative involvement. These cases raise the question of whether the immunologic abnormalities associated with AIDS may affect the clinical characteristics and course of HSV keratitis.
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keywords = keratoconjunctivitis
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6/8. Concurrent adenoviral and herpetic ocular infections.

    We report two cases of a previously unrecognized clinical entity: concurrent adenoviral and herpetic ocular infection. The first case was recognized clinically by the presence of herpetic keratitis and findings attributable to epidemic keratoconjunctivitis (EKC) including lid swelling, pseudomembranous and follicular conjunctivitis, subconjunctival hemorrhages, preauricular lymphadenopathy, and corneal infiltrates. Only herpes simplex virus was recovered by culture. In the second case of apparent EKC (again initially only herpes simplex was isolated) after maintaining virus cultures long enough to isolate adenovirus, the diagnosis of concurrent infection was established when the second virus was isolated.
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keywords = keratoconjunctivitis
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7/8. Primary herpes simplex subepithelial dendritic keratitis.

    A 37-year-old man developed an acute follicular conjunctivitis with preauricular lymphadenopathy believed to be epidemic keratoconjunctivitis. On the eighth day of his disease, subepithelial dendritic opacities developed in the cornea which were not typical of either epidemic keratoconjunctivitis or herpetic keratitis. A diagnosis of primary herpes simplex virus infection was established by positive viral culture and a rise in serum antibody titer to herpes simplex virus. Subepithelial dendritic keratitis as a manifestation of herpes simplex infection of the cornea has not been previously described. The lesions seen in this patient were not reproducible in rabbits and we believe they represent an unusual host response to the virus. This form of herpetic keratoconjunctivitis is extremely difficult to differentiate from epidemic keratoconjunctivitis. Corticosteroids should be used with caution in cases that are not completely typical of epidemic keratoconjunctivitis.
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keywords = keratoconjunctivitis
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8/8. Congenital herpes simplex virus, type 2, bilateral endophthalmitis.

    A set of dizygotic twins, both born prematurely, developed herpes simplex encephalitis shortly after birth. The second twin had unilateral keratoconjunctivitis and bilateral endophthalmitis and subsequently died from disseminated herpes infection. herpes simplex, type 2, was isolated from conjunctiva of both eyes, cerebrospinal fluid, nasopharynx and trachea. Histologic examination of the eyes revealed bilateral endophthalmitis with a necrotizing retinitis. intranuclear inclusion bodies were demonstrated by light microscopy in the retina, choroid and iris, and virus particles were demonstrated by electron microscopy in the retina. The other twin recovered from a much milder disseminated herpes simplex infection without apparent ocular involvement. During pregnancy, the mother had vaginitis which was suspected, but not documented, as being herpetic in origin. The father was diagnosed as having a penile infection caused by herpes simplex. Repeated attempts to locate the family of the surviving baby girl in order to obtain follow-up information have failed.
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