Acute Retinal Necrosis Caused by Herpes Simplex Virus Type 2 in Children: Reactivation of an Undiagnosed Latent Neonatal Herpes Infection

Grose, Charles

doi:10.1016/j.spen.2012.02.005

Cited by 27 publications

(21 citation statements)

References 11 publications

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“…Eight similar published cases exist of HSV-2 reactivation in the eye in children and young adults with asymptomatic perinatal HSV-2 infections. 5 All eight cases had retinal necrosis, a clinical diagnosis for which a biopsy is routinely performed. In the absence of clinical findings of retinal necrosis in this case, neither retinal biopsy nor HSV testing was immediately performed.…”

Section: Discussionmentioning

confidence: 99%

Baylisascaris procyonis and Herpes Simplex Virus 2 Coinfection Presenting as Ocular Larva Migrans with Granuloma Formation in a Child

Liu

Fennelly

Kazacos

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Ocular Baylisascaris procyonis infection results from ingestion of infective eggs of B. procyonis, the raccoon ascarid. Herpes simplex virus type 2 (HSV-2) infection of the retina is the result of either primary infection or reactivated disease. Herein, we report a case of a 12-year-old female resident of the Bronx in New York City, who presented with pan-uveitis and vision loss. Initial evaluation for etiologic causes was nondiagnostic. Serology for anti-Baylisascaris procyonis antibodies in serum and vitreous fluid were both positive. Polymerase chain reaction (PCR) of vitreous fluid was positive for HSV-2. Treatment with vitrectomy, albendazole, and acyclovir resulted in mild improvement of visual acuity. The atypical presentation of B. procyonis in this case, as ocular larva migrans with a peripheral granuloma and retinal detachment, underscores the importance of maintaining a high degree of suspicion for this pathogen even in non-diffuse unilateral subacute neuroretinitis (DUSN) patients in urban areas. This case further illustrates that it is possible to have coexisting infections in cases of posterior uveitis.Baylisascaris procyonis is a large ascarid that commonly parasitizes raccoons in North America and Europe.1 It is a common cause of clinical larva migrans in animals and also affects humans, causing either neural larva migrans (NLM) affecting the nervous system and/or ocular larva migrans (OLM) and diffuse unilateral subacute neuroretinitis (DUSN) causing visual impairment.1-3 Animals and humans become infected by ingesting infective eggs from areas or articles contaminated with raccoon feces. 1 We diagnosed a young girl with Baylisascaris OLM, from the Borough of the Bronx in New York City. This patient is of particular interest because she had an atypical presentation for Baylisascaris OLM and was positive for anti-B. procyonis antibodies in her vitreous fluid as well as being seropositive in serum. In addition, polymerase chain reaction (PCR) testing of the vitreous fluid was positive for Herpes simplex virus-2 (HSV-2) DNA. The patient had mild improvement in visual acuity after diagnostic and therapeutic vitrectomy and treatment with albendazole and acyclovir. CASE REPORTThe patient was a 12-year-old female born and raised in the Bronx, New York City, in an area bordering the suburban County of Westchester. She presented to the emergency department of the Jacobi Medical Center, Bronx, New York City, complaining of "redness and pain" in and about her right eye after reportedly being "poked" in that eye 5 days before. Her medical history included perinatal exposure to human immunodeficiency virus (HIV), bronchiolitis, attention deficit hyperactivity disorder, and she wore corrective glasses for astigmatism from age 2 to 7 years. There was a puppy in the household and she reported having played with several stray cats and had seen raccoons in the neighborhood. There was no history of pica and the remainder of the review of systems was negative.Initially, her best corrected visual acuity wa...

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Section: Discussionmentioning

confidence: 99%

Baylisascaris procyonis and Herpes Simplex Virus 2 Coinfection Presenting as Ocular Larva Migrans with Granuloma Formation in a Child

Liu

Fennelly

Kazacos

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…This is supported by the number of published cases of HSV-2 ARN with neonatal exposure, twice as many of which have been seen in the last decade, compared to those reported in the 1990s. 3,5,6,[9][10][11][12][13][14][15][16][17][18][19][20][21] Although many documented cases of HSV-2 ARN in the literature have a history of neonatal exposure, some patients do not have such histories and the question of how the infection was acquired remains. 21 Grose 21 proposed that neonatal HSV-2 infections may be contracted perinatally as a subclinical skin, eye, or mouth infection.…”

Section: Discussionmentioning

confidence: 99%

Acute retinal necrosis (ARN) in the context of neonatal HSV-2 exposure and subconjunctival dexamethasone: case report and literature review

McGrath¹,

Woods²,

Lee³

et al. 2013

Digit J Ophthalmol

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SummaryHSV-2 is an important cause of the acute retinal necrosis (ARN) syndrome in younger patients. We describe an atypical case of HSV-2 ARN in the context of neonatal exposure and subconjunctival steroid injection. Clinicians should be aware of the association of neonatal or congenital exposure to HSV-2 as a risk factor for this disease because early treatment may improve outcome and/or avoid involvement of both eyes.

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“…In children, HSV-2 retinitis may be due to a delayed reactivation of asymptomatic neonatal HSV infection. 76 HSV posterior uveitis generally has a good prognosis if there is no evidence of ARN. Often the lesions can be treated with systemic acyclovir and corticosteroids with complete resolution of inflammation.…”

Section: Viral Posterior Uveitismentioning

confidence: 99%

“…76 In acquired infections, typical features include vascular sheathing, arteriolar attenuation, hemorrhage, retinal and optic disc edema, multifocal chorioretinitis, and yellowish exudative plaques in the macula and posterior pole. 39,77,228,270 …”

Section: Viral Posterior Uveitismentioning

confidence: 99%

Viral posterior uveitis

Lee

Agarwal

Mahendradas

et al. 2017

Survey of Ophthalmology

111

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The causes of posterior uveitis can be divided into infectious, autoimmune, or masquerade syndromes. Viral infections, a significant cause of sight-threatening ocular diseases in the posterior segment, include human herpesviruses, measles, rubella, and arboviruses such as dengue, West Nile, and chikungunya virus. Viral posterior uveitis may occur as an isolated ocular disease in congenital or acquired infections or as part of a systemic viral illness. Many viruses remain latent in the infected host with a risk of reactivation that depends on various factors, including virulence and host immunity, age, and comorbidities. Although some viral illnesses are self-limiting and have a good visual prognosis, others, such as cytomegalovirus retinitis or acute retinal necrosis, may result in serious complications and profound vision loss. Since some of these infections may respond well to antiviral therapy, it is important to work up all cases of posterior uveitis to rule out an infectious etiology. We review the clinical features, diagnostic tools, treatment regimens, and long-term outcomes for each of these viral posterior uveitides.

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Acute Retinal Necrosis Caused by Herpes Simplex Virus Type 2 in Children: Reactivation of an Undiagnosed Latent Neonatal Herpes Infection

Cited by 27 publications

References 11 publications

Baylisascaris procyonis and Herpes Simplex Virus 2 Coinfection Presenting as Ocular Larva Migrans with Granuloma Formation in a Child

Baylisascaris procyonis and Herpes Simplex Virus 2 Coinfection Presenting as Ocular Larva Migrans with Granuloma Formation in a Child

Acute retinal necrosis (ARN) in the context of neonatal HSV-2 exposure and subconjunctival dexamethasone: case report and literature review

Viral posterior uveitis

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