Case 5: Adenovirus or Thygeson’s Keratitis?

Case 5: Adenovirus or Thygeson’s Keratitis?

Case Report

A 35-year-old woman with irritation in both eyes for 3 days had a bilateral follicular conjunctivitis caused by adenovirus type 4. Eighteen days after the onset of symptoms, she presented again because of she could not see clearly. Both eyes were white but the corneae showed many epithelial infiltrates.

The photographs of the right cornea were taken 18 days after the onset of symptoms.

c

Fig. 3.10 Eighteen days after symptom onset (Ad4). The findings resemble those shown in Fig. 3.9: (a) a lesion (white arrow) lacking defined edges and composed of light-reflecting spots (black arrow) and dots; (b) clumps of material (arrows) suggestive of cell debris; (c) individual rounded/abnormal cells (arrowheads) spread in an in-between area

Comment

Similarly to case 3, in a white eye showing coarse epithelial lesions (infiltrates) the patient’s history is important

for differentiation between adenovirus and Thygeson’s keratitis. In this case, the specimen for virological tests was taken early during the conjunctival stage.