-transparent.png){kind=logo}
OBJECTIVE To characterize further a chronic epithelial keratitis caused by varicella-zoster virus infection in patients with acquired immunodeficiency syndrome (AIDS). METHODS Patients with AIDS and chronic epithelial keratitis associated with varicella-zoster virus from 3 institutions were identified. Patient records were reviewed retrospectively for the following data: medical and demographic characteristics, techniques of diagnosis, physical findings, course, response to treatment, and outcome. RESULTS Sixteen patients were studied. CD4+ T-lymphocyte cell counts were available in 11 patients, with a median of 0.034 x 10(9)/L (range, 0-0.094 x 10(9)/L). Two patients had no history of a zosteriform rash. In the remaining patients, the interval between rash and keratitis ranged from 0 days to 6 years. In all cases, the keratitis was chronic and characterized by gray, elevated, dendriform epithelial lesions that stained variably with fluorescein and rose bengal. The peripheral and midperipheral cornea was most commonly affected, and, in 13 of the 16 patients, the lesions crossed the limbus. Pain was a prominent feature, occurring in 12 of 16 patients. In 9 of 12 patients tested, varicella-zoster virus was identified by culture, direct fluorescent antibody testing, polymerase chain reaction testing, or a combination of these studies, with direct fluorescent antibody testing (6 of 8 positive results) and polymerase chain reaction testing (3 of 3 positive results) appearing to be the most sensitive. Response to antiviral medication was variable. CONCLUSIONS In patients with AIDS, varicella-zoster virus may cause a chronic infection of the corneal epithelium. The keratitis is characterized by dendriform lesions, prolonged course, and frequently by extreme pain. It can occur without an associated dermatitis.
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
May 1988,
American journal of ophthalmology,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
August 1991,
American journal of ophthalmology,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
March 1988,
Journal of the American Academy of Dermatology,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
July 1988,
Archives of dermatology,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
January 2000,
International journal of dermatology,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
July 1993,
American journal of ophthalmology,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
April 1989,
Journal of the American Academy of Dermatology,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
September 1993,
The Journal of pediatrics,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
September 1996,
Cornea,
K C Chern, and
D Conrad, and
G N Holland, and
D S Holsclaw, and
L K Schwartz, and
T P Margolis
February 1990,
Annals of internal medicine,
