Dendritic keratitis caused by an acyclovir-resistant herpes simplex virus with frameshift mutation.

Abstract

PURPOSE:

To report a case of acyclovir-resistant herpes simplex virus (HSV) keratitis after long-term, inconsistent use of topical acyclovir and fluorometholone.

METHODS:

A 70-year-old man with dendritic keratitis caused by an acyclovir-resistant HSV strain was examined. The 50% inhibitory concentration of different antiviral agents against the isolated virus and the DNA sequence of viral thymidine kinase were determined.

RESULTS:

The 50% inhibitory concentration of acyclovir and trifluorothymidine for the isolated HSV strain was 13.75 and 0.28 microg/mL, respectively, indicating that the virus was resistant to acyclovir. DNA sequencing of the viral thymidine kinase revealed that this virus had a frameshift mutant with a G insertion in the 7Gs homopolymer. Topical trifluorothymidine was effective, and the epithelial lesion was completely resolved within 2 weeks.

CONCLUSION:

A typical form of dendritic keratitis was caused by an acyclovir-resistant HSV with frameshift mutation in a 7Gs homopolymer region.

• Authors: Wei Zhang, Takashi Suzuki, Atsushi Shiraishi, Ichiroh Shimamura, Yoshitsugu Inoue, Yuichi Ohashi
• Journal: Cornea (Cornea) Vol. 26 Issue 1 Pg. 105-6 (Jan 2007) ISSN: 0277-3740 [Print] United States
• PMID: 17198024 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antiviral Agents
• DNA, Viral
• Thymidine Kinase
• Acyclovir

Topics

• Acyclovir (therapeutic use)
• Aged
• Antiviral Agents (therapeutic use)
• DNA, Viral (analysis)
• Drug Resistance, Viral
• Frameshift Mutation
• Humans
• Keratitis, Dendritic (drug therapy, virology)
• Male
• Simplexvirus (drug effects, genetics)
• Thymidine Kinase (genetics)