title: Herpetic keratouveitis mixed with bilateral Pseudomonas corneal ulcers in vitamin A deficiency.
abstract: A 56-year-old woman complained of blurred vision and pain in her right eye for several days. Slit lamp examination revealed a large epithelial defect and disciform stromal edema with ring infiltration in her right cornea. Unfortunately, hypopyon and purulent discharge subsequently developed in both eyes. Herpetic keratouveitis and a superimposed pseudomonas infection were diagnosed. A systemic review on the patient showed malnutrition due to her dietary preference and vegetarianism. After the infection was controlled, bilateral epithelial defects persisted for a long time. We performed amniotic membrane transplantation on both eyes and the clinical status improved with administration of vitamin and protein supplements. Although rare in Taiwan, vitamin A deficiency should be kept in mind when conjunctival and corneal xerosis occurred. Vitamin A supplements are suggested because of the increased susceptibility to infection in patients with this clinical status.
authors: Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan.
authors: Hung-Yuan
authors: HY
authors: Hsu
authors: Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan. Electronic address: ilunt@ms49.hinet.net.
authors: I-Lun
authors: IL
authors: Tsai
authors: Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan; Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors: Li-Lin
authors: LL
authors: Kuo
authors: Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan; Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors: Ching-Yao
authors: CY
authors: Tsai
authors: Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan; Department of Ophthalmology, Taipei Medical University, Taipei, Taiwan.
authors: Shiow-Wen
authors: SW
authors: Liou
authors: Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors: Lin-Chung
authors: LC
authors: Woung
mesh_terms: D000650:Amnion / Q000637:transplantation; D003320:Corneal Ulcer / Q000382:microbiology*; D005260:Female; D006801:Humans; D016849:Keratitis, Herpetic / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000175:diagnosis*; D013624:Taiwan; D000066988:Vegetarians; D014801:Vitamin A / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014985:Xerophthalmia / Q000209:etiology*
chemical_list: D014801:Vitamin A
keywords: corneal ulcer; herpetic keratouveitis; vegetarian; vitamin A deficiency; xerophthalmia