Secondary bacterial keratitis in herpes zoster ophthalmicus

We report a case of an unusual complication of herpes zoster ophthalmicus, secondary bacterial keratitis. Compared with previously reported cases, ours is unique in its early occurrence in the course of zoster and the lack of predisposing factors such as steroid use, contact lens use, or prior corneal disease or surgery. The opportunistic pathogen Branhamella cattarhalis responded well to medical therapy. We feel that bacterial superinfection must always be a concern in patients with herpes zoster keratitis, even early in their often prolonged chronic disease.