| Presumptive Diagnosis of Recurrent Herpes-induced Anterior Uveitis with Acute Hypopyon. |
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Han Gyul Yoon, Jinho Jeong, Jin Young Kim |
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Department of Ophthalmology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea. Muse1016@naver.com |
| 전방축농을 동반한 반복적인 헤르페스포도막염 의증 1예 |
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윤한결⋅정진호⋅김진영 |
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제주대학교 의학전문대학원 제주대학교병원 안과학교실 |
Correspondence:
Jin Young Kim,
Email: Muse1016@naver.com
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Received: 31 May 2018 • Revised: 9 July 2018 • Accepted: 27 September 2018 |
| Abstract |
PURPOSE
We report an unusual case of presumptive diagnosis of herpes-induced anterior uveitis with acute hypopyon after trauma. CASE SUMMARY: A 82-year-old male was diagnosed with herpes keratitis due to dendritic keratitis in the left eye, and the lesion disappeared after antiviral treatment. However, 1 year later, the patient visited again with visual loss, pain, and tearing of the left eye after trauma. At the examination, best-corrected visual acuity was counting fingers and the intraocular pressure was 27 mmHg in the left eye. Slit-lamp examination revealed corneal epithelial erosion, moderate corneal edema, and prominent inflammation with 2 mm high hypopyon in the anterior chamber. We thought that bacterial endophthalmitis had rapidly progressed after trauma, so we performed bacterial cultures and an intravitreal antibiotics injection. Considering the clinical manifestations of lesions and herpes keratitis in the past, we could not exclude herpes virus infection. Cultures were negative and the symptoms improved, so the antiviral treatment was gradually reduced and stopped at 2 months. However, recurrence was observed on day 5 after stopping antiviral therapy. We therefore assumed that recurrent herpes virus caused anterior uveitis, and then, antiviral and steroid therapy was resumed. The patient subsequently showed improvement in his symptoms and recovered his visual acuity. CONCLUSIONS: When acute hypopyon is observed in the anterior chamber after trauma, not only bacterial iritis and endophthalmitis but also viral-induced anterior uveitis should be considered in the differential diagnosis. |
| Key Words:
Anterior uveitis;Endophthalmitis;Herpes simplex virus;Hypopyon |
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