Case 3: Adenovirus Type 7 in a Contact Lens Wearer and Her Family

Case Report

In this 29-year-old woman, the disease started with redness and irritation in the right eye; the fellow eye became a ected 5 days later. The symptoms had subsided but for a slight irritation in the left eye. She presented partly because she was a contact lens wearer, and partly because also her daughter and her husband had developed eye symptoms. At presentation, both eyes were white but the left cornea showed two epithelial infiltrates. A week later, all findings were gone.

The patient’s 5-year-old daughter had had fever, sore throat, and pain in the left ear for a week. The right eye was white. The left eye showed a moderate lid swelling, a severe conjunctival injection, conjunctival hemorrhages and erosions, and follicular hyperplasia; the left preauricular lymph node was swollen and tender. A week later, all that was left was only a slight lid swelling and a slight conjunctival injection.

Adenovirus type 7 was found in conjunctival swab performed in the daughter.

The photograph shows the left cornea of the mother, 10 days after the onset of symptoms.

10 days

Fig. 3.8 An epithelial infiltrate (arrow) showing heaped-up rounded/abnormal cells (arrowheads), captured 10 days after the onset of symptoms (Ad7). Rounded/abnormal cells are visible also outside the lesion (arrowheads)

Comment

It is more common that small children become infected in nursery school or kindergarten and transmit the infection to their parents, but in this case it seemed to have been the other way round.

In a white eye, lesions such as that shown in Fig. 3.8 are suggestive of Thygeson’s keratitis. The clue is the patient’s history.