1/6. Delayed onset of varicella keratitis.Although varicella is one of the most common infectious diseases in the united states, systemic and ocular complications are rare. We report a patient who developed disciform edema followed by microdendritic keratitis 1 and 2 months, respectively, after resolution of the acute phase of varicella. Cultures were negative, but serologic analysis found positive antibodies against varicella zoster virus and negative antibodies against herpes simplex virus. Based on this case and on a review of the literature, we believe that this delayed onset of keratitis represents a distinct category of varicella corneal complications.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
2/6. herpes simplex uveitis.BACKGROUND: uveitis in herpes simplex virus (HSV) ocular disease is usually associated with corneal stromal disease. It has generally been believed that herpetic uveitis in the absence of corneal disease is very rare. When seen it is usually attributed to varicella zoster virus (VZV) infections. The diagnosis of uveitis caused by herpes simplex is often not diagnosed resulting in inadequate treatment and a poor visual result. methods: Seven patients from a large uveitis practice who presented with a clinical picture of: anterior uveitis and sectoral iris atrophy without keratitis, a syndrome highly suggestive of herpetic infection, are reported. polymerase chain reaction (PCR) was done in the aqueous of four of them and was positive for HSV. One patient had bilateral disease. Most of the patients also had severe secondary glaucoma. RESULTS: Of the seven patients presented five had no history of any previous corneal disease. Two had a history of previous dendritic keratitis which was not active at the time of uveitis development. One patient with bilateral disease was immunosuppressed at the time when the uveitis developed. Six of the seven patients had elevated intraocular pressures at the time of uveitis and five required glaucoma surgery. Intractable glaucoma developed in two patients leading to rapid and severe visual loss despite aggressive management. CONCLUSION: Findings suggest that uveitis without corneal involvement may be a more frequent manifestation of ocular herpes simplex disease than previously thought. Absence of corneal involvement delays a correct diagnosis and may worsen visual outcome. Primary herpetic uveitis (when there is no history of previous corneal disease) seems to be more severe than the uveitis in patients with previous corneal recurrences. The associated glaucoma may be a devastating complication.- - - - - - - - - - ranking = 0.125keywords = varicella (Clic here for more details about this article) |
3/6. Chronic recurrent varicella-zoster virus keratitis confirmed by polymerase chain reaction testing.PURPOSE: To report a case of chronic recurrent varicella virus epithelial keratitis in a child. DESIGN: Case report. methods: Clinical examination and polymerase chain reaction analysis of corneal epithelium. RESULTS: A 10-year-old healthy child developed chronic recurrent varicella virus keratitis with pseudodendrites after recovering from systemic varicella. Analysis of the debrided pseudodendrites was repeatedly positive for VZV dna and negative for HSV dna. Treatment with oral acyclovir and topical corticosteroid drops was effective in eliminating the pseudodendrites; however, recurrences occurred once the medications were discontinued. CONCLUSIONS: Varicella virus epithelial keratitis in children can be a recurrent chronic condition requiring prolonged treatment.- - - - - - - - - - ranking = 0.875keywords = varicella (Clic here for more details about this article) |
4/6. Pediatric herpes simplex masquerading as varicella-zoster.A three-year-old girl developed a generalized cutaneous herpes simplex infection and a dendritic corneal ulcer. The clinical appearance of the lesions led to the diagnosis of varicella by a pediatrician and of herpes zoster corneal ulcer by an ophthalmologist, who prescribed topical adrenocorticosteroids. An enzyme-linked immunosorbent assay and cultures were positive for the herpes simplex virus. Topical antiviral treatment was applied, and the lesions healed without significant sequelae.- - - - - - - - - - ranking = 0.625keywords = varicella (Clic here for more details about this article) |
5/6. Varicella dendritic keratitis.A 7-year-old boy and a 3-year-old girl suffered from unilateral disciform keratitis and iritis associated with varicella. While they were treated with topical corticosteroid, idoxuridine, and atropine drops, dendritic lesions typical of herpes zoster appeared four months after the onset of eruptive skin lesions. Using the direct immunofluorescent method, we showed varicella-zoster virus antigen in the epithelial cells scraped from the dendritic lesion.- - - - - - - - - - ranking = 0.25keywords = varicella (Clic here for more details about this article) |
6/6. Chronic varicella-zoster virus epithelial keratitis in patients with acquired immunodeficiency syndrome.OBJECTIVE: To characterize further a chronic epithelial keratitis caused by varicella-zoster virus infection in patients with acquired immunodeficiency syndrome (AIDS). methods: patients with AIDS and chronic epithelial keratitis associated with varicella-zoster virus from 3 institutions were identified. Patient records were reviewed retrospectively for the following data: medical and demographic characteristics, techniques of diagnosis, physical findings, course, response to treatment, and outcome. RESULTS: Sixteen patients were studied. CD4 T-lymphocyte cell counts were available in 11 patients, with a median of 0.034 x 10(9)/L (range, 0-0.094 x 10(9)/L). Two patients had no history of a zosteriform rash. In the remaining patients, the interval between rash and keratitis ranged from 0 days to 6 years. In all cases, the keratitis was chronic and characterized by gray, elevated, dendriform epithelial lesions that stained variably with fluorescein and rose bengal. The peripheral and midperipheral cornea was most commonly affected, and, in 13 of the 16 patients, the lesions crossed the limbus. pain was a prominent feature, occurring in 12 of 16 patients. In 9 of 12 patients tested, varicella-zoster virus was identified by culture, direct fluorescent antibody testing, polymerase chain reaction testing, or a combination of these studies, with direct fluorescent antibody testing (6 of 8 positive results) and polymerase chain reaction testing (3 of 3 positive results) appearing to be the most sensitive. Response to antiviral medication was variable. CONCLUSIONS: In patients with AIDS, varicella-zoster virus may cause a chronic infection of the corneal epithelium. The keratitis is characterized by dendriform lesions, prolonged course, and frequently by extreme pain. It can occur without an associated dermatitis.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |