Human Herpesvirus 6: A Casual Or Causal Agent For Keratitis?
Published 2024 - 42nd Congress of the ESCRS
Reference: PP06.11 | Type: Free paper | DOI: 10.82333/jq4f-qm63
Authors: Pablo Torrelo-Navarro* 1 , Jorge Duque-García 1 , Pedro Luis Salvá-Palomeque 1 , Luis García-Onrubia 2 , Nicolás Alejandre-Alba 2
1Ophthalmology,Fundación Jiménez Díaz University Hospital,Madrid,Spain, 2Ophthalmology - Cornea,Fundación Jiménez Díaz University Hospital,Madrid,Spain
Purpose
To describe a case of viral keratitis with a two-phase clinical evolution and a brief review of the literature related to corneal and anterior segment pathologies associated with Human Herpesvirus 6 (HHV-6).
Setting
Case report at Ophthalmology department of "University Hospital Fundación Jiménez Díaz" in Madrid, Spain.
Literature review in health and biomedical search engines.
Methods
Clinical monitorization and evolution of the patient using slit-lamp microscopy and optotype projector.
Literature review using “Human Herpesvirus 6” and “ophthalmology” terms in PubMed and Embase, selecting abstracts related to corneal and ocular surface inflammation or infection with mention of HHV-6.
Results
A 73-year-old female complained of pain and vision loss in her right eye (RE). Weeks before she had a suspected herpetic keratitis with bacterial superinfection by S. epidermidis in her RE. Slit-lamp examination revealed a epithelial defect over a corneal infiltrate. Corneal samples results were positive for K. pneumoniae and HHV-6. Treatment was adjusted with topical and systemic antivirals, topical antibiotics and steroids. After two weeks, improvement in symptoms and clinical signs was achieved: RE exam showed a residual corneal scar with no epithelial defect.
In literature, HHV-6 has been described in sporadic cases of endotheliitis, corneal infiltrates and ulcers, without firm evidence to confirm its role as an etiological agent.Conclusions
HHV-6 has been described as the cause of exanthem subitum in children; and encephalitis, hepatitis, and pneumonitis in immunocompetent and immunosuppressed adult patients. HHV-6 may be another causative agent for corneal ulcers and should be considered in the differential diagnosis. Its presence alone or with other herpes viruses in ocular pathologies should not be a surprise. However, its role in inflammatory and infectious diseases of the ocular surface is yet to be determined.