Bilateral herpes simplex keratitis in a patient with chronic graft-versus-host disease.
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.
Hayashi
Takahiko
T
Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan. amg-igf@goo.jp
Ishioka
Misaki
M
Ito
Norihiko
N
Kato
Yoko
Y
Nakagawa
Hisashi
H
Hatano
Hiroshi
H
Mizuki
Nobuhisa
N