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Dendritic keratitis caused by an acyclovir-resistant herpes simplex virus with frameshift mutation.

Author(s): Zhang W, Suzuki T, Shiraishi A, Shimamura I, Inoue Y, Ohashi Y

Affiliation(s): Department of Ophthalmology, Ehime University School of Medicine, Shitsukawa, Toon-City, Ehime, Japan. zhangwei@m.ehime-u.ac.jp

Publication date & source: 2007-01, Cornea., 26(1):105-6.

Publication type: Case Reports

PURPOSE: To report a case of acyclovir-resistant herpes simplex virus (HSV) keratitis after long-term, inconsistent use of topical acyclovir and fluorometholone. METHODS: A 70-year-old man with dendritic keratitis caused by an acyclovir-resistant HSV strain was examined. The 50% inhibitory concentration of different antiviral agents against the isolated virus and the DNA sequence of viral thymidine kinase were determined. RESULTS: The 50% inhibitory concentration of acyclovir and trifluorothymidine for the isolated HSV strain was 13.75 and 0.28 microg/mL, respectively, indicating that the virus was resistant to acyclovir. DNA sequencing of the viral thymidine kinase revealed that this virus had a frameshift mutant with a G insertion in the 7Gs homopolymer. Topical trifluorothymidine was effective, and the epithelial lesion was completely resolved within 2 weeks. CONCLUSION: A typical form of dendritic keratitis was caused by an acyclovir-resistant HSV with frameshift mutation in a 7Gs homopolymer region.

Page last updated: 2007-05-03

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