A Case Series Of Enterovirus Positive Conjunctivitis And Keratitis

To describe the prevalence and clinical features of cases with PCR-positive enterovirus conjunctivitis or corneal disease.

Case series from the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. All specimens were processed at St Vincent’s Pathology, Melbourne, Australia.

The results from all ocular specimens between April 2019 and May 2020 from the Royal Victorian Eye and Ear Hospital where viral multiplex PCR was requested were analysed. The multiplex panel tests for herpes simplex type 1, herpes simplex type 2, varicella zoster, cytomegalovirus, adenovirus and enterovirus.

There were 81 enterovirus positive cases from 12,289 multiplex PCR results which were available for analysis during the study period. Eighty positive results were obtained from conjunctival or corneal swabs; one was from an aqueous sample. There were no positive results from vitreous specimens. From the 80 positive cases, 50 were cases of conjunctivitis; 28 cases were associated with keratitis, either where a viral aetiology was suspected, or where a swab was performed in conjunction with a corneal scrape in cases of bacterial or fungal keratitis; 3 cases were associated with corneal endothelial failure.

Enterovirus has rarely been associated with conjunctivitis and corneal disease. While no specific treatment is available for enterovirus, this case series confirms that enterovirus is another likely pathogen causing conjunctival and corneal infections.