Download herpes simplex dendritic ulcer


It is a primary, superficial, infective ulcer
having a dendritic shape caused by
Herpes Simplex Virus (epitheliotropic
type).
Dendritic ulcer stained with fluorescin
Herpes Simplex virus
HSV-1 Primarily
HSV-2
responsible,
above
waist
Transmitted
sexually
Orofacial
& ocular
infection
Genital
diseases,
passed to
neonates
1ry HSV-1 infection; in childhood
Direct contact of skin or mucous membrane
with virus-laden lesions or secretions
Virus becomes dormant in trigeminal (V)
ganglion
Inter-neuronal spread
Fever
Menstruation
Low
resistance
Drugs
Psychic
stress
Recurrence occurs with decreased
body resistance
Virus becomes active
Vesicles in mouth, genitalia, cornea

Close-up view of early herpes outbreak
shows small, grouped blisters (vesicles)
and lots of inflammation (erythema).

HSV infection is ubiquitous, with an
estimated one third of the population
worldwide suffering from recurrent
infections.
 Patients
with HSV keratitis may
complain of the following:
› Pain
› Photophobia
› Poor vision
› Profuse lacrimation
› Blepharospasm

Infectious epithelial
keratitis

Corneal stromal
inflammation

Endothelitis

Blepharoconjunctivitis

Dendritic ulcer stained with fluorescin

Dendritic ulcer stained with Rose Bengal
Eye infection
Throat infection
Eczema herpeticum
Erythema multiform
Nervous system
Widespread infection
Bacterial & fungal
keratitis
Peripheral ulcerative
keratitis
Superficial punctate
keratitis
Acanthamoeba
keratitis
Photokeratitis
Interstitial keratitis
Local
• Antiviral
(acyclovir)
• Atropine
• Local
antibiotic
• Bandage
General
• Vit A & Vit C
• Acyclovir
tablet
Resistant
• Debridement
• Cauterization
• Therapeutic
keratopathy