title: Recurrent ocular surface inflammation associated with human herpesvirus 6 infection.
abstract: OBJECTIVE
  To report a case of atypical herpes keratitis and bilateral conjunctivitis associated with human herpesvirus 6 (HHV-6).
  
  
  METHODS
  An immunocompetent 34-year-old man was referred for herpetic epithelial keratitis in his left eye, which was non-responsive to topical acyclovir. Biomicroscopy revealed a central dendritic ulcer with a white stromal infiltrate beneath the ulcer.
  
  
  RESULTS
  The corneal scraping multiplex polymerase chain reaction (CLART ENTHERPEX, Genomica, Spain) was positive for HHV-6 and negative for herpes simplex virus, varicella zoster virus, cytomegalovirus, and Epstein-Barr virus. An improvement of the keratitis and visual acuity was achieved with topical fluorometholone and systemic valacyclovir. One year later, the patient complained of redness of the eyes. A slit-lamp examination disclosed bilateral follicular conjunctivitis, and HHV-6 DNA was once again detected in a conjunctival scraping of both eyes.
  
  
  CONCLUSIONS
  Human herpesvirus 6 may be another causative agent for corneal ulcers and conjunctivitis in isolation. Stromal necrosis is a rare manifestation of herpetic dendritic keratitis. In these cases, we should consider the presence of HHV-6 in the differential diagnosis, even in immunocompetent patients.
authors.affiliation: Departments of Ophthalmology (A.B., A.D., E.G.S., S.M., S.N.); and Microbiology (M.P.R.), La Paz University Hospital, IdiPaz, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Boto-de-los-Bueis
authors.forename: Maria P
authors.initials: MP
authors.lastname: Romero Gómez
authors.forename: Almudena
authors.initials: A
authors.lastname: del Hierro Zarzuelo
authors.forename: Eugenia G
authors.initials: EG
authors.lastname: Sanchez
authors.forename: Soraya
authors.initials: S
authors.lastname: Mediero
authors.forename: Susana
authors.initials: S
authors.lastname: Noval
mesh_terms: D000328:Adult; D003236:Conjunctivitis, Viral / Q000821:virology*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D016849:Keratitis, Herpetic / Q000821:virology*; D008297:Male; D012008:Recurrence