Varicella-zoster virus necrotising retinitis, retinal vasculitis and panuveitis following uncomplicated chickenpox in an immunocompetent child

BMJ Case Rep. 2018 Apr 5;2018:bcr2017223823. doi: 10.1136/bcr-2017-223823.

Abstract

A 4-year-old girl presented with acute left visual loss 4 weeks after uneventful chickenpox. She was found to have left necrotising retinitis and profound retinal vasculitis and vitritis. Aqueous humour was PCR positive for varicella-zoster virus. Combined intravenous and intravitreal antiviral treatment led to rapid improvement with settled retinitis, no vascular occlusion and good recovery of vision. Her recent coinfection with Epstein-Barr virus may have acted to provoke the retinitis.

Keywords: infectious diseases; retina.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Antiviral Agents / therapeutic use
  • Aqueous Humor / virology
  • Chickenpox / complications*
  • Child, Preschool
  • Female
  • Herpes Zoster Ophthalmicus / diagnosis*
  • Herpes Zoster Ophthalmicus / drug therapy
  • Herpes Zoster Ophthalmicus / physiopathology
  • Humans
  • Panuveitis / diagnosis*
  • Panuveitis / drug therapy
  • Panuveitis / physiopathology
  • Panuveitis / virology
  • Retinal Necrosis Syndrome, Acute / diagnosis*
  • Retinal Necrosis Syndrome, Acute / drug therapy
  • Retinal Necrosis Syndrome, Acute / physiopathology
  • Retinal Necrosis Syndrome, Acute / virology
  • Retinal Vasculitis / diagnosis*
  • Retinal Vasculitis / drug therapy
  • Retinal Vasculitis / physiopathology
  • Retinal Vasculitis / virology
  • Treatment Outcome
  • Vision Disorders / diagnostic imaging
  • Vision Disorders / drug therapy
  • Vision Disorders / virology*

Substances

  • Antiviral Agents
  • Acyclovir