Cytomegalovirus keratitis in acute myeloblastic leukemia

A 58-year-old woman presented with acute myeloblastic leukemia (AML) developed a bilateral dendritic epithelial keratitis without retinitis. The patient was initially treated with oral acyclovir with a possible diagnosis of herpes simplex virus (HSV) keratitis. Polymerase chain reaction (PCR) was performed on ocular discharge specimens collected by soft-tipped applicators reported as cytomegalovirus (CMV). Then, acyclovir was discontinued and bilateral CMV keratitis was treated with IV ganciclovir and her epithelial lesions gradually disappeared. The current case report confirms that CMV is capable of generating corneal epithelial engagement without retina involvement and demonstrated that CMV keratitis is an emergent problem of AML. Therefore, in any case with bilateral corneal herpes keratitis, the patient should be evaluated for immune system deficiency.