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Adenovirus epithelial keratitis
J Chodosh1, D Miller, W G Stroop
1Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Florida, USA.
Abstract:
The authors sought to determine whether adenovirus could infect human corneal epithelium in vivo. They reviewed the medical records of six patients with adenovirus-positive viral corneal cultures who were examined at the Bascom Palmer Eye Institute between March 21, 1986, and December 31, 1992. The six patients with adenovirus-positive viral corneal cultures included one patient with dendritic epithelial keratitis, one with geographic epithelial ulceration, three with both geographic ulceration and contiguous dendrites, and one with heaped-up corneal epithelium but no ulceration. Four patients had rose bengal solution applied to their ocular surface, and in all four patients rose bengal uptake was seen at the epithelial edges of the dendrite or geographic ulceration in a manner characteristic of herpes simplex viral keratitis. Serotype determination of the isolates showed adenovirus type 3 (one patient), type 8 (three patients), type 19 (one patient), and indeterminate (one patient). Results of monoclonal antibody staining of cultures against herpes simplex virus (types 1 and 2) antigens was negative for all six cases. Adenovirus epithelial keratitis may result from infection of human corneal epithelium by the virus and rarely may mimic infection of corneal epithelium by herpes simplex virus.
Insights
Adenovirus can infect the human cornea, causing epithelial keratitis. This viral eye infection may mimic herpes simplex virus keratitis, presenting with similar symptoms and requiring accurate diagnosis.
Area of Science:
- Ophthalmology
- Virology
- Microbiology
Background:
- Adenovirus is a common cause of viral conjunctivitis.
- Corneal involvement in adenovirus infections can lead to significant visual impairment.
Observation:
- Medical records of six patients with adenovirus-positive corneal cultures were reviewed.
- Clinical presentations included dendritic epithelial keratitis, geographic epithelial ulceration, or both.
- Rose bengal staining showed uptake at epithelial edges, mimicking herpes simplex virus keratitis.
Findings:
- Adenovirus types 3, 8, and 19 were identified in the corneal cultures.
- Monoclonal antibody staining confirmed the absence of herpes simplex virus antigens.
- Adenovirus infection of the corneal epithelium was confirmed in vivo.
Implications:
- Adenovirus can cause epithelial keratitis in the human cornea.
- Adenoviral keratitis may present with clinical features similar to herpes simplex virus keratitis.
- Accurate differentiation between these viral keratitis types is crucial for appropriate patient management.