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Herpes Simplex Virus-Related Conjunctivitis Resistant to Aciclovir: A Case Report and Review of the Literature
Nira Esra1,2, Roland Hollhumer1,2
1Department of Ophthalmology, University of Witswatersrand, Johannesburg, South Africa; and.
Purpose:
To report a rare case of herpes virus type 2-related conjunctivitis, resistant to aciclovir (ACV).
Methods:
Case report and review of literature.
Results:
A 28-year-old human immunodeficiency virus-positive man presented with chronic, recurrent follicular conjunctivitis. Multiplex reverse transcription polymerase chain reaction assay testing was positive for herpes simplex virus (HSV); subsequent typing with HSV assay revealed the presence of HSV type 2. Oral ACV failed to control the disease, and the patient continued to worsen clinically until resistance testing was performed. This revealed an M183stop within thymidine kinase, thus confirming the suspected resistance. The patient improved after 14 days of high-dose continuous intravenous infusion of ACV.
Conclusions:
This is a rare case of isolated conjunctivitis due to herpes virus type 2, in an human immunodeficiency virus-positive patient, which was found to be resistant to ACV. Drug-resistant HSV is likely to emerge as an important clinical entity in the future, increasing the need for new drugs with novel mechanisms of action.
