[Fulminant acute retinal necrosis 10 months after ipsilateral herpes simplex virus encephalitis - a case report].
BACKGROUND
Cases of acute retinal necrosis caused by herpes simplex virus are rare. We present here a case with a very fast progression 10 months after a primary herpetic encephalitis in an immunocompetent patient.


METHODS
A 36-year-old otherwise healthy man presented in our hospital with an acute painless loss of vision on the left eye. Initial examination of the fundus showed peripheral retinal necrosis with intra- and preretinal haemorrhages and sheathing of retinal venules. Diagnosis was made by detection of viral DNA in vitreous fluid. Although an antiviral therapy with high doses of acyclovir was started, a vitrectomy with silicon oil instillation was necessary to stabilise the necrotic retina.


CONCLUSIONS
Acute retinal necrosis is relatively rare, and fast diagnosis is required. A detailed case history with attention to previous infections with herpes simplex virus as well as clinical signs were the key for the diagnosis.
Bergua
A
A
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen.
Schmidt
B
B
Küchle
M
M
D000328:Adult; D001766:Blindness / Q000209:etiology* / Q000821:virology; D004279:DNA, Viral / Q000302:isolation & purification; D003937:Diagnosis, Differential; D020803:Encephalitis, Herpes Simplex / Q000150:complications*; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D012160:Retina / Q000473:pathology; D015882:Retinal Necrosis Syndrome, Acute / Q000150:complications / Q000175:diagnosis* / Q000628:therapy / Q000821:virology*; D014821:Vitrectomy; D014822:Vitreous Body / Q000821:virology*
D004279:DNA, Viral