Nummular Keratitis Associated with Infectious Mononucleosis

Pinnolis, Michael; McCulley, James P.; Urman, Jeffrey D.

doi:10.1016/0002-9394(80)90167-1

Cited by 36 publications

(7 citation statements)

References 6 publications

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“…EBV is a common infection worldwide with a lifetime prevalence of 90%, with the majority of EBV-related disease in children and young adults [1,4]. In fact, multifocal, pleomorphic or nummular coarse anterior stromal obscurities with unaffected intervening stroma [5,6,8,9]. Three patients presented with multifocal, pleomorphic, full-thickness corneal infiltrates with or without minimal neovascularization [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Nine patients were female (60%) and six were male (40%). Nine patients presented with bilateral corneal involvement (60%), while 6 patients presented with unilateral involvement (40%) [4][5][6][7][8][9].…”

Section: Review Of Casesmentioning

confidence: 99%

“…Our patient was positive for EBEA antibody. Infectious agents ruled out in the literature included syphilis, HSV, adenovirus, CMV, VZV, mumps virus, RSV, and influenza virus [4][5][6][7][8][9] (Table 1).…”

Section: Review Of Casesmentioning

confidence: 99%

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2020

Int J Ophthalmol Clin Res

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Epstein-Barr Virus (EBV), also known as human herpes virus 4, is a DNA virus that causes a range of pathologies. Interstitial keratitis (IK) is a rare manifestation of EBV that is seldomly characterized in the literature. To our knowledge, a review of the clinical presentations and reported treatments of EBV IK has not been conducted. Here, we report a case of EBV IK in a patient and review 14 cases in the literature. The differential diagnosis and identifying clinical characteristics of EBV IK, diagnostic methods used to confirm EBV, and effective treatments are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Review Of Casesmentioning

confidence: 99%

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Untitled

2020

Int J Ophthalmol Clin Res

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“…A supportive treatment with topical or systemic steroids is usually indicated for controlling the symptoms of the ocular surface, as well as corneal and AAU inflammation. Tapered topical prednisolone drops are useful to avoid anterior segment complications (Pinnolis et al 1980;Matoba et al 1986;Sajjadi & Parvin 1994;Cigni et al 2003). However, its benefit in posterior segment involvement remains unclear (Lee & Foster 2010;Victor & Sukmana 2016).…”

Section: Treatmentmentioning

confidence: 99%

Anterior segment involvement in Epstein–Barr virus: a review

Alba‐Linero

Rocha‐de‐Lossada

Rachwani-Anil

et al. 2021

Acta Ophthalmologica

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The aim of this study is to describe the involvement of Epstein-Barr Virus (EBV) in the diseases of the ocular anterior segment. This is a narrative review designed using the PUBMED, SCOPE and Web of Science databases, searching for reported literature on findings in the anterior ocular segment related to EBV between 1990 and 2020. Epstein-Barr Virus (EBV) is implicated in the development of salmoncoloured conjunctival masses in the context of acute mononucleosis and lymphoproliferative disorders. Moreover, EBV can cause haemorrhagic conjunctivitis and its corneal implications appear as different types of keratitis patterns. The involvement of EBV in the pathogenesis of anterior segment inflammation is not well-defined. Current evidence regarding anterior segment disease caused by EBV infection has been proved by positive viral detection through polymerase chain reaction test in eyes with lymphoproliferative disorders known to be caused by EBV, as B-and NK/T-cell lymphoid tumours. Antiviral treatment (oral Aciclovir or Valaciclovir) in anterior segment disease caused by EBV remains controversial.

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“…Miscellaneous complications involving the head and neck rarely reported in patients with infectious mononucleosis include conjunctivitis, nodular episcleritis, keratitis, uveitis, papilledema, sinusitis, periorbital cellulitis and acryocystitis, mastoiditis, subacute thyroiditis, and hairy leukoplakia (Ostler and Thygeson 1976;Pinnolis et al 1980;Sumaya and Neerhout 1976;Fennell and Tomkin 1978;Greenspan, Greenspan, and Lennette 1985).…”

Section: Miscellaneous Complicationsmentioning

confidence: 99%

Infectious Mononucleosis

1989

Clinical Topics in Infectious Disease

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Infectious mononucleosis is a clinical entity characterized by pharyngitis, cervical lymph node enlargement, fatigue and fever, which results most often from a primary Epstein-Barr virus (EBV) infection. EBV, a lymphocrytovirus and a member of the γ-herpesvirus family, infects at least 90% of the population worldwide, the majority of whom have no recognizable illness. The virus is spread by intimate oral contact among adolescents, but how preadolescents acquire the virus is not known. During the incubation period of approximately 6 weeks, viral replication first occurs in the oropharynx followed by viremia as early as 2 weeks before onset of illness. The acute illness is marked by high viral loads in both the oral cavity and blood accompanied by the production of immunoglobulin M antibodies against EBV viral capsid antigen and an extraordinary expansion of CD8 + T lymphocytes directed against EBV-infected B cells. During convalescence, CD8 + T cells return to normal levels and antibodies develop against EBV nuclear antigen-1. A typical clinical picture in an adolescent or young adult with a positive heterophile test is usually sufficient to make the diagnosis of infectious mononucleosis, but heterophile antibodies are not specific and do not develop in some patients especially young children. EBV-specific antibody profiles are the best choice for staging EBV infection. In addition to causing acute illness, long-term consequences are linked to infectious mononucleosis, especially Hodgkin lymphoma and multiple sclerosis. There is no licensed vaccine for prevention and no specific approved treatment. Future research goals are development of an EBV vaccine, understanding the risk factors for severity of the acute illness and likelihood of developing cancer or autoimmune diseases, and discovering anti-EBV drugs to treat infectious mononucleosis and other EBV-spurred diseases.

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Nummular Keratitis Associated with Infectious Mononucleosis

Cited by 36 publications

References 6 publications

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Untitled

Anterior segment involvement in Epstein–Barr virus: a review

Infectious Mononucleosis

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