Herpetic Panophthalmitis: A Diagnostic Dilemma

Abstract

Purpose: To describe an uncommon presentation of ocular infection caused by human herpes simplex virus 2 (HSV-2).Methods: Case report.Results: A 32-year-old female with no prior history of mucocutaneous herpesvirus infection presented with a minimally painful hypertensive granulomatous panophthalmitis and optic neuropathy that was initially suspected to be orbital cellulitis. Her disease progressed despite antibiotic and steroid treatment, and HSV-2 was ultimately identified in the vitreous.Conclusion: Although rare, ocular infection by human herpesvirus can present as a panophthalmitis. The case is discussed in the context of two previously reported cases of herpes simplex panophthalmitis, as well panophthalmitis caused by varicella zoster virus.

Keywords: Acute retinal necrosis; HSV-2; Panophthalmitis.