Peripheral ulcerative keratitis with corneal melt as the primary presentation in a case of human immunodeficiency virus.

BMJ Case Reports
Shokufeh TavassoliKieren Darcy

Abstract

Peripheral ulcerative keratitis (PUK) is an aggressive, potentially sight-threatening cause for peripheral corneal thinning. It is thought to be the result of immune complex deposition at the limbus, resulting in corneal inflammation and stromal melt. We present a case of a 43-year-old female patient of African origin, presenting with PUK and associated corneal perforation as the primary presentation of HIV infection. An urgent tectonic deep anterior lamellar keratoplasty was performed under general anaesthesia with excellent outcome. The patient was referred to the sexual health clinic and anti-retroviral treatment was initiated. This case is to the best of our knowledge the first report from the UK of PUK with corneal perforation as the primary presentation of HIV infection. As highlighted in this report, infection with HIV may initially be silent; therefore, it is vital to consider HIV infection when dealing with PUK of unknown aetiology.

References

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Dec 16, 1998·Optometry and Vision Science : Official Publication of the American Academy of Optometry·J Y Seino, S F Anderson
Apr 18, 2001·Journal of Clinical Pathology·R Chetty
Oct 13, 2006·The British Journal of Ophthalmology·Muthaiah SrinivasanEmmett T Cunningham
Jun 2, 2012·Clinical Ophthalmology·Ayse Yagci
Jan 15, 2014·AIDS·Schalk H Du Toit, Derrick P Smit

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