非典型性基质单纯疱疹性角膜炎：临床特征与诊断。
Atypical stromal herpes simplex keratitis: clinical features and diagnosis.
机构信息
Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China.
出版信息
Jpn J Ophthalmol. 2023 Jan;67(1):43-49. doi: 10.1007/s10384-022-00963-8. Epub 2022 Nov 11.
PURPOSE
To report atypical clinical features and diagnosis of stromal herpes simplex keratitis (HSK) and to evaluate the diagnostic efficiency of tear HSV-sIgA in atypical HSK.
STUDY DESIGN
Prospective observational study.
METHODS
Records of keratitis' patients with tear herpes simplex virus (HSV)-sIgA test results acquired between May 2019 and November 2021 were evaluated retrospectively. Positive tear HSV-sIgA test was used to identify herpes simplex virus (HSV) infection. Patients with typical presentations and histories of HSV keratitis (HSK) were excluded.
RESULTS
Eleven eyes of 11 patients initially diagnosed as keratitis caused by other etiology were confirmed as having HSV infection by positive results of tear HSV-sIgA. Clinical features of atypical stromal HSK were variable. Antiviral treatment was effective in all patients.
CONCLUSION
The appearance of an atypical stromal HSK represents a diagnostic challenge. Tear HSV-sIgA test could help provide a quick diagnosis.
目的
报告基质单纯疱疹性角膜炎（HSK）的非典型临床特征和诊断，并评估泪液单纯疱疹病毒（HSV）-sIgA 在非典型 HSK 中的诊断效率。
研究设计
前瞻性观察研究。
方法
回顾性分析 2019 年 5 月至 2021 年 11 月期间获取的角膜炎患者的泪液单纯疱疹病毒（HSV）-sIgA 检测结果的记录。阳性的泪液 HSV-sIgA 检测用于确定单纯疱疹病毒（HSV）感染。排除具有典型 HSV 角膜炎（HSK）表现和病史的患者。
结果
11 例患者的 11 只眼最初被诊断为其他病因引起的角膜炎，通过泪液 HSV-sIgA 检测阳性结果证实为 HSV 感染。非典型基质 HSK 的临床表现多样。所有患者的抗病毒治疗均有效。
结论
出现非典型基质 HSK 是一个诊断挑战。泪液 HSV-sIgA 检测有助于快速诊断。
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