Open AccessAcute retinal necrosis by herpes simplex virus type 1: an unusual presentation of a primary infection
Author(s) -
Gonçalo Cruz,
Cristina Fonseca,
Joaquim Oliveira,
José Saraiva da Cunha
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-232566
Subject(s) - medicine , acute retinal necrosis , foscarnet , encephalitis , herpes simplex virus , methylprednisolone , meningitis , aciclovir , retinitis , dermatology , surgery , virus , immunology , herpesviridae , viral disease , human cytomegalovirus
Herpes simplex virus (HSV) can affect the central nervous system causing meningitis, encephalitis and, rarely, acute retinal necrosis. We present a case of a 46-year-old man, previously healthy complaining of a 5-day persistent headache and sudden loss of vision of his left eye that progressed to the right. We started ceftriaxone, methylprednisolone and acyclovir for suspected encephalitis with vasculitis. HSV-1 was identified in vitreous and aqueous humour. Therapy with acyclovir was maintained and two intravitreous boluses of foscarnet were administered, without improvement. Usually being a benign infection, HSV can, in rare cases like this, have catastrophic effects in the optic tract.