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Cytomegalovirus keratitis in acute myeloblastic leukemia

Seyed-Hashem Daryabari1, Seyed Aliasghar Mosavi2,3, Mohsen Moghtaderi1

  • 1Chemical Injuries Research Center, Systems Biology and Poisonings Institutes, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Oman Journal of Ophthalmology
|August 21, 2023
PubMed

Insights

Cytomegalovirus (CMV) can cause bilateral keratitis in acute myeloblastic leukemia (AML) patients, even without retinal involvement. Early diagnosis and treatment with ganciclovir are crucial for resolving CMV epithelial lesions.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Hematology

Background:

  • Acute myeloblastic leukemia (AML) is a hematologic malignancy that can compromise immune function.
  • Herpes simplex virus (HSV) keratitis is a common cause of corneal inflammation.
  • Cytomegalovirus (CMV) is an opportunistic pathogen that can affect immunocompromised individuals.

Observation:

  • A 58-year-old woman with AML presented with bilateral dendritic epithelial keratitis.
  • Initial treatment for suspected HSV keratitis with oral acyclovir was ineffective.
  • Ocular discharge PCR identified Cytomegalovirus (CMV).

Findings:

  • The patient was diagnosed with bilateral CMV epithelial keratitis.
  • Intravenous ganciclovir treatment led to the resolution of corneal epithelial lesions.
  • This case highlights CMV's ability to cause corneal epithelial disease independently of retinitis.

Implications:

  • CMV keratitis is an emergent complication in patients with AML.
  • Bilateral herpetic-like keratitis in immunocompromised patients warrants evaluation for CMV infection.
  • Prompt diagnosis and appropriate antiviral therapy are essential for managing CMV keratitis in AML patients.

Keywords:
Acute myeloblastic leukemiacorneal herpes keratitiscytomegaloviruspolymerase chain reaction

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