Case Report

Varicella Related Keratoconjunctivitis; Case Report

10.5152/imj.2013.48344

  • Erkan Ünsal
  • Tanju Çelik
  • Ayşe Tekin Buyrukçu
  • Osman Kızılay
  • Kadir Eltutar

Received Date: 23.11.2012 Accepted Date: 16.02.2013 İstanbul Med J 2013;14(4):294-296

Chickenpox is the primary infection of Varicella-zoster virus (VZV) and is often seen in childhood with fever and a vesiculo-bullous rash and causes severe systemic illness and complications. In this article we aimed to present a case of keratoconjunctivitis due to chicken pox. A nine-year-old patient with chickenpox was examined in our clinic. Vesiculo-bullous lesions were present on the body and face. She had redness, pain, and tear complaints in her left eye. Keratoconjunctivitis was detected in the left eye at 7 o’clock. In this area, there were sectorial type conjunctival hyperemia and slight chemosis. Limbal vesicular lesions, punctate keratitis and anterior stromal infiltrate were detected. Topical acyclovir 3% (5x1) and prophylactic topical fusidic acid 1% (2x1) were administered to the patient. All complaints and findings showed improvement on the 7. day of the treatment. Varicella-zoster virus causes chickenpox and shingles. While chickenpox is the primary infection of VZV, recurrent Herpes zoster infections occur by reactivation of latent virus in the dorsal root ganglion. Chickenpox rarely affects the eye except for the typical eyelid lesions. However, a few conjunctival and corneal lesions, iridocyclitis, glaucoma, chorioretinitis and optic nerve lesions have been described. VZV dendrites are composed of plaques blistered from the surface of the cornea and swollen epithelial cells. Dendrites form branches or a “medusa like” pattern with conical ends. While antiviral treatment is not necessary in healthy children, a variety of antiviral treatments such as acyclovir, famciclovir and valacyclovir can be used in immune compromised patients. In our case, an adequate response to topical acyclovir treatment was obtained. Our case of varicella keratoconjunctivitis was successfully treated with topical acyclovir. There were no additional complications during follow-up. We want also to emphasize that, in varicella keratonjunctivitis, eye examinations should be repeated.

Keywords: Pox, varicella-zoster virus (VZV), keratoconjunctivitis, vesiculo-bullous