Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, 05278, Seoul, Korea.
BMC Ophthalmol. 2021 Mar 2;21(1):113. doi: 10.1186/s12886-021-01878-7.
Hand, foot, and mouth disease (HFMD) is a common systemic infection that is caused by an enterovirus, normally Coxsackie A16. Generally, it affects children or immunocompromised adults. Only a few reports have described pseudomembranous conjunctivitis associated with HFMD. We aim to describe the clinical outcomes and ocular findings of a 37-year-old female with HFMD and concurrent severe pseudomembranous conjunctivitis, who was 28 weeks pregnant.
A female patient who was 28-weeks pregnant was referred for an ophthalmological review due to pain and injection in both eyes. The patient was hospitalized under obstetrics and gynecology and evaluated for Behcet's disease with oral and perineal ulcers. In an ophthalmic examination, both eyes were observed to have a conjunctival injection. Behcet's disease-associated conjunctivitis was diagnosed. Topical steroids and antibiotics were administered every 6 h. Two days after her presentation, a maculopapular eruption occurred on her palms. Enterovirus type 71 was detected in a serum virus antibody test, and the patient was diagnosed with HFMD. After 7 days, severe pseudomembranous conjunctivitis and corneal epithelial defects occurred in both eyes. Topical steroids were administered every 3 h, and the pseudomembrane was removed every 2 to 3 days. The pseudomembrane did not occur after 3 weeks, but corneal erosion persisted. After 3 months, the corneal erosion had completely resolved.
HFMD-associated conjunctivitis is a rare complication in adults, however it can appear as a severe pseudomembranous conjunctivitis. In this case, the removal of the pseudomembrane and topical steroids helped improve the symptoms.
手足口病（HFMD）是一种常见的全身性感染，由肠道病毒引起，通常为柯萨奇 A16 型。它通常影响儿童或免疫功能低下的成年人。仅有少数报道描述了与手足口病相关的伪膜性结膜炎。我们旨在描述一名 37 岁女性的临床结果和眼部发现，该女性患有手足口病且并发严重的伪膜性结膜炎，同时处于 28 周妊娠。
一名 28 周妊娠的女性因双眼疼痛和充血而被转介至眼科进行检查。该患者被收入妇产科病房，并因口腔和会阴溃疡而接受贝切特病的评估。在眼科检查中，发现双眼结膜充血。诊断为贝切特病相关性结膜炎。给予每 6 小时一次的局部类固醇和抗生素治疗。就诊后两天，手掌出现斑丘疹。血清病毒抗体检测发现肠道病毒 71 型，患者被诊断为手足口病。7 天后，双眼出现严重伪膜性结膜炎和角膜上皮缺损。给予每 3 小时一次的局部类固醇治疗，每 2 至 3 天清除一次伪膜。3 周后，伪膜未再出现，但角膜侵蚀仍持续存在。3 个月后，角膜侵蚀完全愈合。
成人手足口病相关性结膜炎是一种罕见的并发症，但它可能表现为严重的伪膜性结膜炎。在这种情况下，清除伪膜和局部使用类固醇有助于改善症状。
