Primary varicella-zoster keratitis: diagnosis by polymerase chain reaction

Am J Ophthalmol. 1997 Feb;123(2):252-4. doi: 10.1016/s0002-9394(14)71043-8.


Purpose: To report the value of polymerase chain reaction in the diagnosis of a worsening corneal ulcer.

Methods: A 6-year-old boy underwent an emergent penetrating keratoplasty for a corneal ulcer that continued to worsen despite intensive antibiotic therapy.

Results: Examination of the corneal specimen by polymerase chain reaction was positive for varicella-zoster virus but negative for herpes simplex. Based on polymerase chain reaction studies, we diagnosed primary varicella-zoster keratitis with corneal perforation. Electron microscopy showed herpetic virus particles in the cornea.

Conclusions: Polymerase chain reaction analysis of corneal buttons at the time of penetrating keratoplasty may benefit patients with undiagnosed recalcitrant corneal ulcers.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Cornea / pathology
  • Cornea / virology
  • Corneal Transplantation
  • Corneal Ulcer / surgery
  • Corneal Ulcer / virology
  • Herpes Zoster / diagnosis*
  • Herpesvirus 3, Human / isolation & purification
  • Humans
  • Keratitis / diagnosis*
  • Keratitis / virology*
  • Keratoplasty, Penetrating
  • Male
  • Microscopy, Electron
  • Polymerase Chain Reaction*