Herpetic Panophthalmitis: A Diagnostic Dilemma

ABSTRACT

Purpose: To describe an uncommon presentation of ocular infection caused by human herpes simplex virus 2 (HSV-2).

Methods: Case report.

Results: A 32-year-old female with no prior history of mucocutaneous herpesvirus infection presented with a minimally painful hypertensive granulomatous panophthalmitis and optic neuropathy that was initially suspected to be orbital cellulitis. Her disease progressed despite antibiotic and steroid treatment, and HSV-2 was ultimately identified in the vitreous.

Conclusion: Although rare, ocular infection by human herpesvirus can present as a panophthalmitis. The case is discussed in the context of two previously reported cases of herpes simplex panophthalmitis, as well panophthalmitis caused by varicella zoster virus.

Keywords:

• HSV-2
• Panophthalmitis
• Acute retinal necrosis

Declaration of Interest

None of the authors have any relevant conflicts of interests. The authors alone are responsible for the content and writing of the paper. The views expressed in this manuscript are the authors’ own and do not officially reflect the position of the Flaum Eye Institute or the Research to Prevent Blindness.

Consent

Our patient consented to this report of her case. She has not been personally identified in this manuscript.

Additional information

Funding

This work was supported by the Flaum Eye Ophthalmology Department at the University of Rochester Medical Center through an unrestricted RPB grant.