Acute retinal necrosis secondary to multidrug-resistant herpes simplex virus 2 in an immunocompetent adolescent

Adrian T. Dokey, Sara J. Haug, H. Richard McDonald, Emmett T. Cunningham, Brandon Lujan, Arthur D. Fu, J. Michael Jumper

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Purpose: To report the clinical course of a patient with acute retinal necrosis resulting from a multidrug-resistant strain of herpes simplex virus 2. Methods: Observational case report. Results: A 17-year-old man with no identifiable immune deficiency presented with pain and decreased vision in his left eye. He had dense anterior and posterior segment inflammation with retinal whitening suggestive of acute retinal necrosis, which progressed despite treatment with intravenous acyclovir, methylprednisolone, and ganciclovir. A transition to intravitreal and intravenous foscarnet led to clinical improvement. Genetic analysis revealed the etiology to be a multidrug-resistant strain of herpes simplex virus 2. Conclusion: Antiviral resistance is an uncommon finding among viruses causing acute retinal necrosis in immunocompetent patients. Patients with these infections may be adequately treated with prompt recognition and a change in therapy to alternative antiviral agents such as foscarnet.

Original languageEnglish (US)
Pages (from-to)260-264
Number of pages5
JournalRetinal Cases and Brief Reports
Volume8
Issue number4
StatePublished - 2014
Externally publishedYes

Keywords

  • Acute retinal necrosis
  • Acyclovir resistance
  • HSV
  • HSV retinitis
  • Multidrug resistance

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

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  • Cite this

    Dokey, A. T., Haug, S. J., McDonald, H. R., Cunningham, E. T., Lujan, B., Fu, A. D., & Jumper, J. M. (2014). Acute retinal necrosis secondary to multidrug-resistant herpes simplex virus 2 in an immunocompetent adolescent. Retinal Cases and Brief Reports, 8(4), 260-264.