Journal article
Acute retinal necrosis in a patient with remote severe herpes simplex encephalitis
BMJ case reports, Vol.12(5), e229137
05/2019
DOI: 10.1136/bcr-2018-229137
PMCID: PMC6557359
PMID: 31138593
Abstract
A 60-year-old man with a history of severe herpes simplex virus type 1 (HSV-1) encephalitis 2 years prior presented with acute onset of visual loss in the left eye. Dilated funduscopic examination showed retinitis and occlusive vasculitis with retinal necrosis. PCR of the vitreous fluid was positive for HSV-1, and he was diagnosed with acute retinal necrosis (ARN) due to HSV-1. The patient was treated with intravenous acyclovir and intravitreous foscarnet for 2 weeks, followed by high dose oral valacyclovir for 2 weeks. He was subsequently placed on planned life-long suppressive valacyclovir. His case demonstrates that acute visual loss concomitant with or subsequent to HSV-1 encephalitis warrants suspicion of ARN. Prompt therapy with effective antiviral medication is necessary to reduce the risk of sight-threatening complications. Chronic suppression with oral antiviral therapy after ARN is recommended to prevent involvement of the contralateral eye, though there is no consensus on the duration and dosage of antivirals.
Details
- Title: Subtitle
- Acute retinal necrosis in a patient with remote severe herpes simplex encephalitis
- Creators
- Takaaki Kobayashi - University of IowaPoorani Sekar - University of IowaJeffery Meier - University of Iowa Hospitals and ClinicsJudy Streit - University of Iowa
- Resource Type
- Journal article
- Publication Details
- BMJ case reports, Vol.12(5), e229137
- DOI
- 10.1136/bcr-2018-229137
- PMID
- 31138593
- PMCID
- PMC6557359
- ISSN
- 1757-790X
- eISSN
- 1757-790X
- Language
- English
- Date published
- 05/2019
- Academic Unit
- Infectious Diseases; Epidemiology; Internal Medicine
- Record Identifier
- 9984362673502771
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