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CASE REPORT
Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 251-252

Double trouble - Fungal keratitis with concomitant presumed herpes simplex virus keratouveitis


1 Cornea and Anterior Segment Service, The Cornea Institute, LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India
2 Ocular Microbiology Service, LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India

Correspondence Address:
Dr. Merle Fernandes
Cornea and Anterior Segment Service, The Cornea Institute, L V Prasad Eye Institute, GMR Varalakshmi Campus, Hanumanthawaka Jn, Visakhapatnam - 530 040, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2493_20

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A gentleman with microbiological proven fungal keratitis developed pigmented keratic precipitates with increased anterior chamber reaction on antifungals. Presumed HSV iritis was suspected. Topical steroids were contraindicated. Complete resolution was observed with oral Acyclovir and anti-fungal therapy. A year later acute granulomatous anterior uveitis occurred which responded to topical steroids but progressed to corneal melt with perforation. Following penetrating keratoplasty, he has a clear graft and 20/80 vision. Concomitant HSV iritis with active fungal keratitis is extremely rare. This management dilemma necessitated only oral Acyclovir while continuing anti-fungal therapy while avoiding steroids for HSV kerato-uveitis.


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