Vol. 5 No. 1 (2027): Vol. 5 Núm. 1 (2027): Enero - marzo 2027: Revista Multidisciplinaria Investigación Contemporánea
Ciencias de la Salud- Caso clínico

Epithelial and Stromal Herpetic Keratitis in a Pediatric Patient: A Case Report

DOI: 10.58995/redlic.rmic.v5.n1.a224
María Isabel Sánchez Dávila
Hospital de Niños Dr. Roberto Gilbert Elizalde, Guayaquil, Ecuador
Bio
Ericka Andreina Intriago Rengifo
Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
Bio
Carlos Antonio Domínguez Coello
Bio

Abstract

Herpetic keratitis is a corneal infection caused by herpes simplex virus type 1 and represents one of the leading causes of infectious corneal blindness worldwide. In the pediatric population, it accounts for approximately 10–15% of cases and is associated with a high risk of recurrence and permanent visual sequelae. We report the case of a 7-year-old male who presented with fever, ocular pain, photophobia, and periocular vesicular lesions affecting the left eye. Ophthalmologic examination revealed conjunctival hyperemia, central corneal opacity consistent with leukoma, and characteristic dendritic lesions compatible with epithelial and stromal herpetic keratitis. Management included surgical debridement, topical and systemic antiviral therapy, and prophylactic antibiotic treatment, resulting in favorable clinical evolution. This case emphasizes the importance of early recognition of characteristic clinical findings and timely multidisciplinary management to prevent severe complications such as corneal thinning, perforation, and permanent vision loss.

Downloads

Download data is not yet available.

References

  1. Farooq AV, Shukla D. Herpes simplex epithelial and stromal keratitis: an epidemiologic update. Surv Ophthalmol. 2012;57(5):448-462. https://doi.org/10.1016/j.survophthal.2012.01.005 DOI: https://doi.org/10.1016/j.survophthal.2012.01.005
  2. Looker KJ, Magaret AS, May MT, Turner KME, Vickerman P, Gottlieb SL, Newman LM. Global and regional estimates of prevalent and incident herpes simplex virus type 1 infections in 2012. PLoS One. 2015;10(10):e0140765. https://doi.org/10.1371/journal.pone.0140765 DOI: https://doi.org/10.1371/journal.pone.0140765
  3. Kaye SB, Choudhary A. Herpes simplex keratitis. Prog Retin Eye Res. 2022;87:100997. https://doi.org/10.1016/j.preteyeres.2021.100997 DOI: https://doi.org/10.1016/j.preteyeres.2021.100997
  4. Wilhelmus KR. Antiviral treatment and prophylaxis of herpes simplex virus eye disease. Curr Opin Ophthalmol. 2021;32(4):314-320. https://doi.org/10.1097/ICU.0000000000000762 DOI: https://doi.org/10.1097/ICU.0000000000000762
  5. Liesegang TJ. Classification of herpes simplex virus keratitis and anterior uveitis. Cornea. 2021;40(9):1141-1151. https://doi.org/10.1097/ICO.0000000000002645 DOI: https://doi.org/10.1097/ICO.0000000000002645
  6. Sukik L, Alyafei M, Harfouche M, et al. Herpes simplex virus type 1 epidemiology in Latin America and the Caribbean: systematic review and meta-analysis. PLoS One. 2019;14(4):e0215487. https://doi.org/10.1371/journal.pone.0215487 DOI: https://doi.org/10.1371/journal.pone.0215487
  7. Toma HS, Murillo-Solís AA. Pediatric herpes simplex keratitis: current challenges in diagnosis and management. J Pediatr Ophthalmol Strabismus. 2020;57(6):379-388. https://doi.org/10.3928/01913913-20201019-01 DOI: https://doi.org/10.3928/01913913-20201019-01
  8. Bodack MI. Pediatric herpes simplex keratitis. Optom Vis Sci. 2019;96(4):275-280. https://doi.org/10.1097/OPX.0000000000001353 DOI: https://doi.org/10.1097/OPX.0000000000001345
  9. Ulman EA, Acar DE, Yilmaz GC, et al. Clinical features of pediatric herpes simplex keratitis. Ocul Immunol Inflamm. 2024;32(3):459-465. https://doi.org/10.1080/09273948.2023.2194537
  10. Valerio GS, Lin CC, Moss WN, et al. Ocular manifestations of herpes simplex virus. Curr Opin Ophthalmol. 2022;33(6):539-544. https://doi.org/10.1097/ICU.0000000000000901 DOI: https://doi.org/10.1097/ICU.0000000000000901
  11. Azher TN, Yin XT, Tajfirouz D, et al. Herpes simplex keratitis: challenges in diagnosis and clinical management. Clin Ophthalmol. 2017;11:185-191. https://doi.org/10.2147/OPTH.S80475 DOI: https://doi.org/10.2147/OPTH.S80475
  12. Labib BA, Chigbu DI. Clinical management of herpes simplex virus keratitis. Diagnostics. 2022;12(10):2368. https://doi.org/10.3390/diagnostics12102368 DOI: https://doi.org/10.3390/diagnostics12102368
  13. Sridhar U, Tripathy K. Commentary: Herpes simplex virus stromal keratitis preferred practice patterns among ophthalmologists vis-à-vis the Herpetic Eye Diseases Study. Indian J Ophthalmol. 2021;69(5):1340-1341. https://doi.org/10.4103/ijo.IJO_636_21 DOI: https://doi.org/10.4103/ijo.IJO_636_21
  14. Herpetic Eye Disease Study Group. Oral acyclovir for herpes simplex virus eye disease. Arch Ophthalmol. 2000;118(8):1030-1036. https://doi.org/10.1001/archopht.118.8.1030 DOI: https://doi.org/10.1001/archopht.118.8.1030
  15. Herpetic Eye Disease Study Group. Acyclovir for prevention of recurrent herpes simplex virus eye disease. N Engl J Med. 1998;339:300-306. https://doi.org/10.1056/NEJM199807303390503 DOI: https://doi.org/10.1056/NEJM199807303390503
  16. Hsiao CH, Yeung L, Yeh LK, Kao LY, Tan HY, Wang NK, Lin KK, Ma DH. Pediatric herpes simplex virus keratitis. Cornea. 2009;28(3):249-253. https://doi.org/10.1097/ICO.0b013e3181839aee DOI: https://doi.org/10.1097/ICO.0b013e3181839aee
  17. Schwartz GS, Holland EJ. Oral acyclovir for management of herpes simplex keratitis in children. Ophthalmology. 2000;107(2):278-282. https://doi.org/10.1016/S0161-6420(99)00052-4 DOI: https://doi.org/10.1016/S0161-6420(99)00052-4
  18. Luccarelli SV, Cheshmier A, Goldhardt R. Impact of adherence to oral acyclovir prophylaxis in pediatric herpetic keratitis. Cornea. 2021;40(5):602-606. https://doi.org/10.1097/ICO.0000000000002499 DOI: https://doi.org/10.1097/ICO.0000000000002499
  19. Liesegang TJ. Epidemiology of ocular herpes simplex. Cornea. 2001;20(1):1-13. https://doi.org/10.1097/00003226-200101000-00001 DOI: https://doi.org/10.1097/00003226-200101000-00001
  20. Young RC, Hodge DO, Liesegang TJ, Baratz KH. Incidence, recurrence, and outcomes of herpes simplex virus eye disease in Olmsted County, Minnesota, 1976–2007. Arch Ophthalmol. 2010;128(9):1178-1183. https://doi.org/10.1001/archophthalmol.2010.187 DOI: https://doi.org/10.1001/archophthalmol.2010.187

Published 2027-01-01

Keywords

  • herpetic keratitis,
  • corneal ulcer,
  • pediatrics,
  • herpes simplex virus,
  • case report

How to Cite

Sánchez Dávila , M. I. ., Intriago Rengifo, E. A. ., & Domínguez Coello, C. A. . (2027). Epithelial and Stromal Herpetic Keratitis in a Pediatric Patient: A Case Report. Contemporary Research, 5(1). https://doi.org/10.58995/redlic.rmic.v5.n1.a224