title: Bilateral herpes simplex keratitis in a patient with chronic graft-versus-host disease.
abstract: OBJECTIVE
  To describe a case of bilateral herpes simplex keratitis accompanying chronic graft-versus-host disease (GVHD).
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  An 11-year-old boy with myelocytic leukemia underwent allogeneic bone marrow transplantation. He developed symptoms of the skin, eyes, and mouth, and lip biopsy indicated chronic GVHD. Persistent keratitis with corneal filaments and neovascularization was noted in both eyes. Sodium hyaluronate, autoserum, and 0.1% fluorometholone eyedrops were instilled for approximately 2 years to treat this keratitis, and there were no other ocular changes. Bilateral herpes simplex keratitis developed with geographic ulcers after topical betamethasone therapy, but responded to acyclovir ointment.
  
  
  CONCLUSIONS
  Herpes keratitis should be considered in the differential diagnosis of bilateral keratitis in patients with reduced immunocompetence. During the course of chronic GVHD, corneal herpes may occur, so ocular treatment with topical corticosteroids should be managed by an ophthalmologist to monitor sight-threatening conditions such as corneal herpes.
authors: Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan. amg-igf@goo.jp
authors: Takahiko
authors: T
authors: Hayashi
authors: Misaki
authors: M
authors: Ishioka
authors: Norihiko
authors: N
authors: Ito
authors: Yoko
authors: Y
authors: Kato
authors: Hisashi
authors: H
authors: Nakagawa
authors: Hiroshi
authors: H
authors: Hatano
authors: Nobuhisa
authors: N
authors: Mizuki