Cytomegalovirus keratitis in acquired immunodeficiency syndrome
K. R. Wilhelmus, R. L. Font, R. P. Lehmann and P. L. Cernoch
Department of Ophthalmology Cullen Eye Institute, Baylor College of Medicine, Houston, Tex., USA.
A man with acquired immunodeficiency syndrome developed a generalized rash
and bilateral dendritic epithelial keratitis without retinitis. Cytologic
examination of superficial corneal scrapings showed many megalosyncytial
giant cells that were highly characteristic of cytomegalovirus (CMV)
infection. Viral cultures yielded CMV from 2 separate specimens obtained by
corneal epithelial debridement from both eyes. The slightly elevated,
opaque, branching, nonulcerative epitheliopathy recurred after corneal
scrapings and persisted despite oral and topical antiviral therapy. Stromal
keratouveitis subsequently developed. This case report confirms that CMV
can produce corneal involvement and suggests that CMV keratitis may be an
emergent complication of acquired immunodeficiency syndrome.
