title: An atypical case of herpes simplex virus endotheliitis presented as bullous keratopathy.
abstract: OBJECTIVE
  To present an atypical case of herpes simplex virus (HSV) endotheliitis.
  
  
  METHODS
  The authors report the case of a 62-year-old female patient who presented with unilateral diffuse corneal edema with Descemet's membrane folds and bullae, without keratic precipitates, iritis, significant anterior chamber reaction, or intraocular pressure (IOP) elevation. The patient had no documented positive history of ocular surgery and no abnormal findings were present in the fellow eye. Endotheliitis of viral origin was suspected and Goldmann-Witmer coefficient for HSV, cytomegalovirus, and varicela zoster virus was calculated.
  
  
  RESULTS
  Goldmann-Witmer coefficient was positive for HSV. Treatment with oral valacyclovir and topical dexamethasone resulted in complete resolution of corneal edema within 1 week.
  
  
  CONCLUSIONS
  HSV endotheliitis can present with bullous keratopathy as the only clinical manifestation, without typical findings such as keratic precipitates, iritis, and IOP elevation.
authors: Cornea Clinic, 2nd Ophthalmology Department, Attikon University Hospital , Athens , Greece.
authors: Lamprini
authors: L
authors: Papaioannou
authors: Georgios
authors: G
authors: Tsolkas
authors: Panagiotis
authors: P
authors: Theodossiadis
authors: Miltiadis
authors: M
authors: Papathanassiou
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D015715:Corneal Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004279:DNA, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D004728:Endothelium, Corneal / Q000473:pathology / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D018139:Simplexvirus / Q000235:genetics*
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral