Infection of the corneal endothelium in herpes simplex keratitis.

PURPOSE

To describe viral infection of the corneal endothelium in a patient with recurrent herpes simplex virus keratitis in the corneal graft.

METHODS

Case report. A healthy 28-year-old man presented with necrotizing stromal keratitis and corneal perforation in the corneal graft. A second penetrating keratoplasty was performed. The corneal button was processed for histopathologic, immunohistochemical, and electron microscopic studies.

RESULTS

Histopathologically, the corneal endothelium showed viral inclusion bodies. Herpes simplex virus antigens and viral particles were identified in stromal keratocytes and corneal endothelial cells.

CONCLUSION

Productive herpes simplex virus infection of the corneal endothelial cells may contribute to corneal graft failure in recurrent herpes simplex virus infections.