valacyclovir and Necrosis

A 25-year-old woman presented with redness, pain, and diminution of vision that occurred 2 weeks after microkeratome-assisted laser in situ keratomileusis (LASIK). On presentation, corneal edema, Descemet membrane folds, keratic precipitates, stromal infiltrates, and flap necrosis were observed. Delayed post-LASIK microbial keratitis was diagnosed. The patient had no history of ocular herpes. Culture and scraping showed no organisms. Immunofluorescence stain was positive for the herpes simplex virus antigen. The patient was started on oral valacyclovir, and progress was monitored through serial clinical photographs and anterior segment optical coherence tomography. Resolution began within 3 days of initiating treatment and was complete in 4 weeks.

Topics: Acyclovir; Administration, Oral; Adult; Antigens, Viral; Antiviral Agents; Corneal Stroma; Female; Humans; Keratitis, Herpetic; Keratomileusis, Laser In Situ; Myopia; Necrosis; Postoperative Complications; Simplexvirus; Surgical Flaps; Tomography, Optical Coherence; Uveitis, Anterior; Valacyclovir; Valine

To report recurrent conjunctivitis and scleritis secondary to coexistent conjunctival pemiphigus vulgaris and cryptic herpes simplex infection.. Case report.. Retrospective review.. A 54-year-old woman presented with recurrent left eye irritation and redness. Four years earlier, she was diagnosed (biopsy) with cutaneous pemphigus vulgaris requiring immunomodulatory therapies. She was receiving oral acyclovir for recurrent genital herpes and intravenous immunoglobulin for pemphigus. Examination revealed unilateral necrotizing scleritis and conjunctivitis. Immunohistochemical staining of biopsies demonstrated conjunctival pemphigus and herpes in conjunctiva and sclera. Valacyclovir therapy brought resolution.. Cryptic ocular herpes may confound matters in someone with an autoimmune disease thought to be the sole source of ocular inflammation. Immunohistochemical analysis can resolve the mystery.

Topics: Acyclovir; Antiviral Agents; Conjunctival Diseases; Conjunctivitis; Female; Herpes Simplex; Humans; Immunoglobulins, Intravenous; Medical Records; Middle Aged; Necrosis; Pemphigus; Recurrence; Retrospective Studies; Scleritis; Valacyclovir; Valine

The tongue is a common location for Horton necrotic injuries. But some herpetic lesions can show similar symptoms to the disease and complicate the diagnosis.. A 67-year-old woman, treated by corticosteroids for Horton disease, presented a central, deep, and very painful ulceration of the tongue. The spreading of necrosis despite treatment was an indication for biopsy, giving the diagnosis of herpetic infection. Valacyclovir was efficient within 15 days.. This necrotic injury looks like herpetic stomatitis presented by severely immunodeficient AIDS patients. No case under corticosteroids had been described so far. The tongue-limited location is exceptional.

Topics: Acyclovir; Aged; Antiviral Agents; Female; Giant Cell Arteritis; Glucocorticoids; Humans; Necrosis; Prednisone; Stomatitis, Herpetic; Tongue Diseases; Valacyclovir; Valine

Topics: Acyclovir; Aged; Antiviral Agents; Diagnosis, Differential; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Necrosis; Nose; Palate, Hard; Valacyclovir; Valine