Herpes simplex keratitis-induced endophthalmitis in a patient with AIDS with disseminated tuberculosis

BMJ Case Rep. 2014 Feb 27:2014:bcr2013202804. doi: 10.1136/bcr-2013-202804.

Abstract

We present the case of a 42-year-old man with AIDS who had lost complete vision of his left eye for the past 15 days. MRI and brightness scan ultrasonography were performed on his eyes that suggested of endophthalmitis with dendritic involvement in the left eye. Viral DNA PCR was performed in aqueous humour sample that confirmed the presence of herpes simplex virus and showed a negative result for cytomegalovirus. The patient was treated with a high dose of oral acyclovir for 10 days and long-term topical acyclovir. Neodymium-doped yttrium aluminum garnet procedure was performed to clear up the cornea, and intraocular pressure was controlled with brimonidine and timolol maleate. The patient was diagnosed to have disseminated tuberculosis (tuberculoma of the brain) and was started with antituberculosis therapy. His condition improved significantly after the treatment, and keratitis in cornea started to clean up.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / complications*
  • AIDS-Related Opportunistic Infections / drug therapy
  • Acyclovir / therapeutic use
  • Adult
  • Antitubercular Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Endophthalmitis / virology*
  • Humans
  • Keratitis, Herpetic / complications*
  • Keratitis, Herpetic / drug therapy
  • Male
  • Tuberculosis / complications*
  • Tuberculosis / drug therapy

Substances

  • Antitubercular Agents
  • Antiviral Agents
  • Acyclovir