Case of bilateral multiple herpetic epithelial keratitis manifested as dendriform epithelial edema during primary Kaposi's varicelliform eruption.
BACKGROUND
Bilateral herpetic keratitis has been reported in patients with atopy, measles, graft-versus-host disease, and altered immune status. We report a serologically verified case of primary, simultaneous onset, bilateral, atypical epithelial herpetic keratitis that manifested as dendriform epithelial edema during a generalized dermatitis incident.


METHODS
A 37-year-old man with chronic atopic dermatitis developed Kaposi's varicelliform eruption and bilateral dendritic epithelial keratitis with corneal epithelial edema.


METHODS
The pathogens isolated from both eyes were identified as herpes simplex virus type 1 (HSV-1) by a direct immunofluorescence method. Serological tests obtained on three different occasions over a 5-week period verified a primary HSV infection.


CONCLUSIONS
With serological verification, we report a rare case of primary, simultaneous onset, bilateral, dendritic epithelial keratitis at a very early stage with complications of generalized herpetic disease in a patient with atopic dermatitis.
Higaki
Shiro
S
Department of Ophthalmology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
Inoue
Yoshitsugu
Y
Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. yoinoue@grape.med.tottori-u.ac.jp.
Yoshida
Atsushi
A
Department of Ophthalmology and Visual Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Maeda
Naoyuki
N
Department of Ophthalmology and Visual Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Watanabe
Hitoshi
H
Department of Ophthalmology and Visual Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Shimomura
Yoshikazu
Y
Department of Ophthalmology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use; D000287:Administration, Topical; D000328:Adult; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood; D002522:Chlorocebus aethiops; D015715:Corneal Edema / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D003588:Cytopathogenic Effect, Viral; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D019573:Epithelium, Corneal / Q000473:pathology / Q000821:virology*; D019085:Fluorescent Antibody Technique, Direct; D007839:Functional Laterality; D018259:Herpesvirus 1, Human / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007275:Injections, Intravenous; D007617:Kaposi Varicelliform Eruption / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D007635:Keratitis, Dendritic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D008297:Male; D009824:Ointments; D014709:Vero Cells / Q000821:virology
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D009824:Ointments; D000212:Acyclovir