Inoda S, Wakakura M, Hirata J, Nakazato N, Toyo-Oka Y
Department of Ophthalmology, Kitasato University, Sagamihara, Kanagawa, Japan.
Jpn J Ophthalmol. 2001 Nov-Dec;45(6):618-21. doi: 10.1016/s0021-5155(01)00409-9.
An uncommon case of stromal keratitis and anterior uveitis due to herpes simplex virus type 2 (HSV-2) is reported.
The patient was a 3-year-old boy admitted for conjunctival injection of the right eye of unknown cause, accompanied by corneal opacity and anterior uveitis.
High titers of antibodies against HSV and Epstein-Barr virus (EBV) were found in blood samples. Polymerase chain reaction (PCR) for the detection of HSV-1, -2, and EBV genome fragments was carried out using an anterior chamber sample as a template. An HSV-2 genome fragment was amplified by PCR. Administration of acyclovir and betamethasone was started, with the consequent elimination of corneal opacity, inflammatory cells, and keratic precipitates.
PCR clearly showed that HSV-2 was the causative pathogen of the stromal keratitis and anterior uveitis in this young patient. Systemic EVB infection may induce systemic immunocompromised conditions that can lead to reactivation of HSV-2 followed by ocular disorders.
报告了一例由2型单纯疱疹病毒(HSV - 2)引起的基质性角膜炎和前葡萄膜炎的罕见病例。
该患者为一名3岁男孩,因右眼不明原因结膜充血入院,伴有角膜混浊和前葡萄膜炎。
在血液样本中发现了高滴度的抗HSV和爱泼斯坦 - 巴尔病毒(EBV)抗体。以前房样本为模板进行聚合酶链反应(PCR)以检测HSV - 1、-2和EBV基因组片段。通过PCR扩增出HSV - 2基因组片段。开始给予阿昔洛韦和倍他米松治疗,随后角膜混浊、炎症细胞和角膜后沉着物消失。
PCR明确显示HSV - 2是该年轻患者基质性角膜炎和前葡萄膜炎的致病病原体。全身性EBV感染可能诱发全身性免疫功能低下状态,导致HSV - 2重新激活,继而引发眼部疾病。