acyclovir and Eyelid-Diseases

Necrotising fasciitis is a rare severe infection of the soft tissues and deep fascia, which is associated with a significant level of mortality. Involvement of the head and neck is uncommon, and necrotising fasciitis of the periorbital area even rarer. We present a case of bilateral periorbital necrotising fasciitis following shingles in an otherwise healthy immunocompetent patient.

Topics: Acyclovir; Debridement; Eye Infections, Viral; Eyelid Diseases; Fasciitis, Necrotizing; Female; Follow-Up Studies; Herpes Zoster; Herpesvirus 3, Human; Humans; Middle Aged; Rare Diseases; Severity of Illness Index; Treatment Outcome

Ocular herpes simplex is usually diagnosed by its typical clinical presentation. It is generally accepted to be a unilateral disease, with lid eruptions typically occurring in primary ocular herpes simplex, while absent or mild in recurrent disease. Recurrent ocular herpes simplex is generally thought to be characterized by corneal involvement.. A 35-year-old woman had a 2-day history of a progressive bilateral, erythematous, vesicular rash of the upper and lower eyelids and associated preseptal cellulitis. She had a history of a recurrent, unilateral eyelid rash that was previously diagnosed as herpes zoster. The eyelid involvement was unusual because it was bilateral, severe, recurrent, vesicular, and isolated, with no additional ocular manifestations of herpes simplex. These atypical features are in contrast to the generally accepted manifestations of recurrent ocular herpes simplex. A cytologic evaluation and a viral culture confirmed infection by HSV Type 1.. Lid involvement occurs in recurrent ocular herpes simplex disease more often than generally accepted, while simultaneous bilateral disease is uncommon. As in this case, when atypical presentations occur, critical review of the differential diagnosis and use of laboratory tests are helpful.

Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Eye Infections, Viral; Eyelid Diseases; Eyelids; Female; Follow-Up Studies; Herpes Simplex; Herpesvirus 1, Human; Humans; Recurrence

Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Blepharitis; Eye Infections, Viral; Eyelid Diseases; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Male; Skin Ulcer; Valacyclovir; Valine

Topics: Acyclovir; Administration, Oral; Antiviral Agents; Child; Erythema Multiforme; Eye Infections, Viral; Eyelid Diseases; Herpes Simplex; Herpesvirus 1, Human; Humans; Male

Topics: Acyclovir; Antiviral Agents; Eyelid Diseases; Female; Herpes Zoster Ophthalmicus; Humans; Middle Aged; Treatment Outcome; Valacyclovir; Valine

A 24-year-old black female (HIV-positive) was referred to our clinic with a 4-week history of an ulcerative lesion of the right upper and lower eyelids. She was on treatment for pulmonary tuberculosis and had been admitted to a secondary level hospital. She had no other ocular symptoms or signs. A tissue biopsy of the lesion revealed multinucleate squamous cells with ground glass viral nuclear inclusion bodies, indicative of herpes simplex virus (HSV) infection. The ulcer healed with oral and topical acyclovir therapy, confirming a herpetic origin. There is only one other reported case of this type of ulcerative eyelid lesion caused by HSV; the patient in this case was also immunocompromised.

Topics: Acyclovir; Adult; Antiviral Agents; Eyelid Diseases; Female; Herpes Simplex; HIV Infections; Humans; Opportunistic Infections; Ulcer; Young Adult

A 68-year-old woman presented with unilateral herpetiform skin lesions of the face. She also showed reduced eye lid and mimic function as well as hearing loss. In addition grouped vesicles were seen in the outer ear canal. We diagnosed Ramsay Hunt syndrome and administered intravenous acyclovir, prednisolone and pentoxifylline. Within a few weeks, there was complete remission including the neurological symptoms.

Topics: Acyclovir; Aged; Anti-Inflammatory Agents; Antiviral Agents; Dermatitis Herpetiformis; Diagnosis, Differential; Eyelid Diseases; Facial Dermatoses; Female; Free Radical Scavengers; Hearing Loss, Sensorineural; Herpes Zoster Oticus; Humans; Neurologic Examination; Pentoxifylline; Prednisolone

We report the case of a 34-year-old man who had uncomplicated cataract surgery in his left eye. Medical history was significant for atopic dermatitis, requiring oral immunosuppressive medications. Two days after the surgery, the patient presented with pain, photophobia, decreased vision, and a small corneal abrasion. On postoperative day 5, the patient returned with left upper lid vesicular lesions and 2 corneal dendrites. Corrected vision was 20/100 OS, with intraocular pressure of 18 mm Hg and 1+ pigmented cells in the anterior chamber. Cultures of the lid lesions revealed herpes simplex virus (HSV) type 1. The patient was placed on oral acyclovir 800 mg 5 times a day. By day 8, the dendrites had resolved, and by day 15, the lid lesions healed over. HSV keratitis is an uncommon complication after cataract surgery. Ophthalmologists should be aware of the possibility of developing HSV keratitis even after the most routine cataract extraction.

Topics: Acyclovir; Administration, Oral; Adult; Anti-Inflammatory Agents; Antifungal Agents; Antiviral Agents; Cataract Extraction; Drug Administration Schedule; Drug Therapy, Combination; Eyelid Diseases; Herpes Simplex; Humans; Keratitis, Herpetic; Male; Postoperative Complications; Prednisolone; Treatment Outcome; Wound Healing

Topics: Acyclovir; Adolescent; Anti-Bacterial Agents; Antiviral Agents; Cloxacillin; Dermatitis, Atopic; Drug Therapy, Combination; Eyelid Diseases; Female; Follow-Up Studies; Humans; Kaposi Varicelliform Eruption; Ointments; Time Factors; Treatment Outcome

The purpose of this case series was to present an overview of the nature and frequency of ocular complications in the Department of Defense (DoD) Smallpox Vaccination Program.. Retrospective, noncomparative case series.. The authors retrospectively evaluated data collected on individuals with an ophthalmologic complaint after receiving smallpox vaccination or after contact with a recently immunized individual. The vaccinee and contact cases occurred secondary to inoculations given between December 13, 2002 and May 28, 2003 as part of the DoD Smallpox Vaccination Program.. Data were collected primarily from reports to military headquarters or to the Vaccine Adverse Event Reporting System and individual medical records.. The incidence, types, and timing of ocular complications were evaluated. Diagnostic and treatment considerations also were reviewed.. Between December 13, 2002 and May 28, 2003, 450,293 smallpox vaccinations were given. We identified 16 confirmed or probable cases of ocular vaccinia, with an incidence of 3.6 per 100,000 inoculations. Of these cases, 12 (75%) were seen in the vaccinees, and 4 (25%) in close contacts. Of the 12 self-inoculation cases, 7 (58.3%) were seen in individuals receiving the vaccine for the first time (primary vaccination), and 3 (25.0%) were seen in individuals previously vaccinated (revaccination); the vaccination status in 2 cases was unknown. Clinical manifestations included lid pustules, blepharitis, periorbital cellulitis, conjunctivitis, conjunctival ulcers, conjunctival membranes, limbal pustules, corneal infiltrates, and iritis, with onset of symptoms 3 to 24 days after inoculation or contact. Five of 9 tested cases were culture or polymerase chain reaction positive for vaccinia. Treatment for most cases was topical trifluridine 1% (Viroptic; King Pharmaceuticals, Inc., Bristol, TN). Vaccinia immune globulin was used in 1 case. In all patients, recovery occurred without significant visual sequelae.. When compared with historical data on the ocular complications of smallpox vaccination, the incidence of ocular complications during the DoD Smallpox Vaccination program has been low. In addition, the severity of disease seems to be less than during other vaccination periods. These findings perhaps are the result of improved screening of vaccinees, prevaccination counseling, postvaccination wound care, and the suggested efficacy of trifluridine in the treatment of ocular vaccinia.

Topics: Acyclovir; Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Antiviral Agents; Conjunctival Diseases; Corneal Diseases; Eye Infections, Viral; Eyelid Diseases; Female; Humans; Immunization Programs; Incidence; Infection Control; Male; Middle Aged; Military Medicine; Military Personnel; Retrospective Studies; Smallpox Vaccine; Trifluridine; United States; Vaccination; Vaccinia

We studied a case of acute retinal necrosis in which a 30-year delay occurred between involvement of the first and fellow eyes. After systemic treatment with acyclovir and prednisolone, the fellow eye developed a retinal detachment requiring vitrectomy and silicone oil tamponade.. The fellow eye retained a useful Snellen acuity of 20/120. In a patient who has had acute retinal necrosis, any symptoms or signs in the fellow eye, even several decades later, should alert the examining physician to the possibility of delayed involvement of the fellow eye.

Topics: Acyclovir; Eye Infections, Viral; Eyelid Diseases; Female; Herpes Simplex; Humans; Middle Aged; Prednisolone; Retinal Detachment; Retinal Necrosis Syndrome, Acute; Silicone Oils; Time Factors; Visual Acuity; Vitrectomy

Topics: Acyclovir; Adult; Edema; Eyelid Diseases; Facial Dermatoses; Herpes Simplex; Humans; Hypersensitivity, Immediate; Isotretinoin; Male

Topics: Acyclovir; Aged; Disease Susceptibility; Eyelid Diseases; Female; Herpes Zoster Ophthalmicus; Humans

The incidence and severity of herpes zoster ophthalmicus have increased because of the growing number of immunocompromised patients. Uveitis and keratitis are the most common inflammatory complications. Corneal exposure from scarring and contraction of the upper lid may require reconstructive plastic surgery. Preliminary studies of oral acyclovir, specifically targeted at preventing ocular complications, are encouraging.

Topics: Acyclovir; Antiviral Agents; Conjunctivitis, Viral; Eyelid Diseases; Female; Herpes Zoster Ophthalmicus; Humans; Immune Tolerance; Keratitis; Male; Orbital Diseases; Retinal Diseases; United States; Uveitis, Anterior