Which physical findings are characteristic of ocular herpes simplex virus (HSV) infections?

Updated: Feb 27, 2019
  • Author: J Michael Klatte, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Herpes simplex virus infection of the eye presents as blepharitis, follicular conjunctivitis, or keratoconjunctivitis. Signs include corneal or conjunctival injection, watery discharge, lid swelling, and preauricular adenopathy.

Patients with Mollaret meningitis present with fever, nuchal rigidity, and transitory neurologic findings that accompany meningeal irritation.

Patients with eczema herpeticum are more frequently affected over the head, neck, and trunk than elsewhere on the body. Although the lesions begin to appear over eczematous areas of skin, they can spread to involve normal areas of skin approximately 7-10 days into the course of the illness. Lesional spread to the eye can cause keratoconjunctivitis. Fevers are present in approximately half of children with eczema herpeticum. [65] Secondary bacterial infections with staphylococci and streptococci are present in up to 90% of children with eczema herpeticum. [69]


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