Two Patients With the von Szily Reaction: Herpetic Keratitis and Contralateral Retinal Necrosis

Lynnelle K. Smith, Paul A. Kurz, David J. Wilson, Christina J. Flaxel, James T. Rosenbaum

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Purpose: To present two patients with prior unilateral, herpetic keratitis who developed acute retinal necrosis (ARN) in the contralateral eye. These cases have noticeable similarities to the von Szily reaction. This describes the development of a contralateral retinitis subsequent to an anterior chamber injection of herpes simplex virus (HSV). Design: Interventional case series. Methods: Retrospective chart and literature review. Results: The first patient had neonatally acquired herpetic keratitis and developed ARN at age 21. Polymerase chain reaction of a vitreous biopsy detected HSV type-2 (HSV-2). The second patient was clinically diagnosed with ARN contralateral to varicella zoster keratitis. A detailed literature search located seven prior case reports with a von Szily reaction. These resembled our two cases except none had HSV-2 or years of latency from keratitis to retinitis. Conclusions: Clinicians need to be cognizant of the von Szily reaction.

Original languageEnglish (US)
Pages (from-to)536-538
Number of pages3
JournalAmerican journal of ophthalmology
Volume143
Issue number3
DOIs
StatePublished - Mar 2007

ASJC Scopus subject areas

  • Ophthalmology

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