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. 2000 Sep;84(9):968–972. doi: 10.1136/bjo.84.9.968

Clinical and epidemiological features of acute follicular conjunctivitis with special reference to that caused by herpes simplex virus type 1

E Uchio 1, S Takeuchi 1, N Itoh 1, N Matsuura 1, S Ohno 1, K Aoki 1
PMCID: PMC1723617  PMID: 10966946

Abstract

BACKGROUND/AIMS—It is reported by the national surveillance of ocular infectious diseases in Japan that 4.3% of cases of epidemic keratoconjunctivitis (EKC) diagnosed clinically were caused by herpes simplex virus (HSV). Clinical and virological studies of patients with HSV conjunctivitis were carried out.
METHODS—The study population consisted of 478 patients with acute follicular conjunctivitis. Virological analysis was carried out for adenovirus (Ad) and HSV by the cell culture method and fluorescein antibody (FA) method. Polymerase chain reaction for Chlamydia trachomatis was also carried out.
RESULTS—From 23 patients, HSV type 1 was isolated but Ad or C trachomatis was not isolated. 87% of cases were unilateral. Most cases showed clinical resolution within 9 days. Early corneal lesions and preauricular lymphadenopathy were less frequent in HSV conjunctivitis than in adenoviral conjunctivitis, especially that due to subgenus D. No case showed a positive result for HSV by the FA method using conjunctival swabs; however, the FA test was positive in all strains isolated by cell culture.
CONCLUSIONS—These results indicate that it is difficult clinically to differentiate HSV conjunctivitis from adenoviral conjunctivitis in the acute stage, since the clinical features of adenoviral conjunctivitis are similar to those of HSV conjunctivitis. A biological difference may exist between HSV strains causing keratitis and conjunctivitis.



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Figure 1  .

Figure 1  

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Duration of conjunctivitis. Most cases showed clinical resolution within 9 days (mean, 8.1 days).

Figure 2  .

Figure 2  

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Moderate case of herpes simplex virus conjunctivitis. A 66 year old man, 4 days after the onset. Dot haemorrhages are seen on the palpebral conjunctiva.

Figure 3  .

Figure 3  

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Moderate case of herpes simplex virus conjunctivitis. A 28 year old man, 3 days after the onset. Conjunctival follicles and hyperaemia are evident on the lower palpebral conjunctiva.

Figure 4  .

Figure 4  

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Severe case of herpes simplex virus conjunctivitis. A 56 year old woman, 5 days after the onset. Diffuse subconjunctival haemorrhage is present.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aoki K., Kawana R., Matsumoto I., Wadell G., de Jong J. C. Viral conjunctivitis with special reference to adenovirus type 37 and enterovirus 70 infection. Jpn J Ophthalmol. 1986;30(2):158–164. [PubMed] [Google Scholar]
  2. Aono T., Murakami S., Yanagihara N., Yamanishi K. Detection of human alpha-herpesvirus DNA using consensus primers and specific probes. Acta Otolaryngol Suppl. 1994;514:132–134. doi: 10.3109/00016489409127577. [DOI] [PubMed] [Google Scholar]
  3. Belongia E. A., Goodman J. L., Holland E. J., Andres C. W., Homann S. R., Mahanti R. L., Mizener M. W., Erice A., Osterholm M. T. An outbreak of herpes gladiatorum at a high-school wrestling camp. N Engl J Med. 1991 Sep 26;325(13):906–910. doi: 10.1056/NEJM199109263251302. [DOI] [PubMed] [Google Scholar]
  4. Buehler J. W., Finton R. J., Goodman R. A., Choi K., Hierholzer J. C., Sikes R. K., Elsea W. R. Epidemic keratoconjunctivitis: report of an outbreak in an ophthalmology practice and recommendations for prevention. Infect Control. 1984 Aug;5(8):390–394. doi: 10.1017/s0195941700062238. [DOI] [PubMed] [Google Scholar]
  5. Darougar S., Quinlan M. P., Gibson J. A., Jones B. R. Epidemic keratoconjunctivitis and chronic papillary conjunctivitis in London due to adenovirus type 19. Br J Ophthalmol. 1977 Feb;61(2):76–85. doi: 10.1136/bjo.61.2.76. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Darougar S., Wishart M. S., Viswalingam N. D. Epidemiological and clinical features of primary herpes simplex virus ocular infection. Br J Ophthalmol. 1985 Jan;69(1):2–6. doi: 10.1136/bjo.69.1.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dawson C. R., Togni B. Herpes simplex eye infections: clinical manifestations, pathogenesis and management. Surv Ophthalmol. 1976 Sep-Oct;21(2):121–135. doi: 10.1016/0039-6257(76)90090-4. [DOI] [PubMed] [Google Scholar]
  8. Field P. R., Ho D. W., Irving W. L., Isaacs D., Cunningham A. L. The reliability of serological tests for the diagnosis of genital herpes: a critique. Pathology. 1993 Apr;25(2):175–179. doi: 10.3109/00313029309084794. [DOI] [PubMed] [Google Scholar]
  9. Goldstein L. C., Corey L., McDougall J. K., Tolentino E., Nowinski R. C. Monoclonal antibodies to herpes simplex viruses: use in antigenic typing and rapid diagnosis. J Infect Dis. 1983 May;147(5):829–837. doi: 10.1093/infdis/147.5.829. [DOI] [PubMed] [Google Scholar]
  10. Harding S. P., Mallinson H., Smith J. L., Clearkin L. G. Adult follicular conjunctivitis and neonatal ophthalmia in a Liverpool eye hospital, 1980-1984. Eye (Lond) 1987;1(Pt 4):512–521. doi: 10.1038/eye.1987.77. [DOI] [PubMed] [Google Scholar]
  11. Hidaka Y., Sakuma S., Kumano Y., Minagawa H., Mori R. Characterization of glycoprotein C-negative mutants of herpes simplex virus type 1 isolated from a patient with keratitis. Arch Virol. 1990;113(3-4):195–207. doi: 10.1007/BF01316673. [DOI] [PubMed] [Google Scholar]
  12. Hierholzer J. C., Guyer B., O'Day D., Schaffner W. Letter: Adenovirus type 19 keratoconjunctivitis. N Engl J Med. 1974 Jun 20;290(25):1436–1436. doi: 10.1056/nejm197406202902512. [DOI] [PubMed] [Google Scholar]
  13. Ishii K., Nakazono N., Fujinaga K., Fujii S., Kato M., Ohtsuka H., Aoki K., Chen C. W., Lin C. C., Sheu M. M. Comparative studies on aetiology and epidemiology of viral conjunctivitis in three countries of East Asia--Japan, Taiwan and South Korea. Int J Epidemiol. 1987 Mar;16(1):98–103. doi: 10.1093/ije/16.1.98. [DOI] [PubMed] [Google Scholar]
  14. Isobe K., Aoki K., Itoh N., Ohno S., Takashima I., Hashimoto N. Serotyping of Chlamydia trachomatis from inclusion conjunctivitis by polymerase chain reaction and restriction fragment length polymorphism analysis. Jpn J Ophthalmol. 1996;40(2):279–285. [PubMed] [Google Scholar]
  15. Kawana T., Kurata T., Sata T., Kawana R., Satoh S., Tamaki K., Kukita A., Niimura M., Ohki Y., Tezuka T. [Detection of herpes simplex virus (HSV) infection by using FITC-labeled monoclonal antibodies (MicroTrak method)]. Kansenshogaku Zasshi. 1987 Sep;61(9):1030–1037. doi: 10.11150/kansenshogakuzasshi1970.61.1030. [DOI] [PubMed] [Google Scholar]
  16. Kumano Y., Yamamoto M., Inomata H., Sakuma S., Hidaka Y., Minagawa H., Mori R. Recurrent herpetic keratitis: failure to detect herpes simplex virus infection using the Syva MicroTrak HSV1/HSV2 direct specimen identification/typing test. Ophthalmologica. 1990;201(4):169–173. doi: 10.1159/000310147. [DOI] [PubMed] [Google Scholar]
  17. Nowinski R. C., Tam M. R., Goldstein L. C., Stong L., Kuo C. C., Corey L., Stamm W. E., Handsfield H. H., Knapp J. S., Holmes K. K. Monoclonal antibodies for diagnosis of infectious diseases in humans. Science. 1983 Feb 11;219(4585):637–644. doi: 10.1126/science.6297006. [DOI] [PubMed] [Google Scholar]
  18. Sakai Y., Minagawa H., Ishibashi T., Inomata H., Mori R. Stromal keratitis induced by a unique clinical isolate of herpes simplex virus type 1. Ophthalmologica. 1994;208(3):157–160. doi: 10.1159/000310474. [DOI] [PubMed] [Google Scholar]
  19. Svennerholm B., Jeansson S., Vahlne A., Lycke E. Involvement of glycoprotein C (gC) in adsorption of herpes simplex virus type 1 (HSV-1) to the cell. Arch Virol. 1991;120(3-4):273–279. doi: 10.1007/BF01310482. [DOI] [PubMed] [Google Scholar]
  20. Swenson P. D., Lowens M. S., Celum C. L., Hierholzer J. C. Adenovirus types 2, 8, and 37 associated with genital infections in patients attending a sexually transmitted disease clinic. J Clin Microbiol. 1995 Oct;33(10):2728–2731. doi: 10.1128/jcm.33.10.2728-2731.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Tada A., Yoshino K. A new microplate neutralization test for typing of herpes simplex virus. Microbiol Immunol. 1978;22(7):415–426. doi: 10.1111/j.1348-0421.1978.tb00387.x. [DOI] [PubMed] [Google Scholar]
  22. Tal-Singer R., Peng C., Ponce De Leon M., Abrams W. R., Banfield B. W., Tufaro F., Cohen G. H., Eisenberg R. J. Interaction of herpes simplex virus glycoprotein gC with mammalian cell surface molecules. J Virol. 1995 Jul;69(7):4471–4483. doi: 10.1128/jvi.69.7.4471-4483.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]

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