Bilateral microbial keratitis in highly active antiretroviral therapy-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: a case series.

Abstract

PURPOSE:

To report three cases of bilateral microbial keratitis in eyes with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) induced by highly active antiretroviral therapy (HAART) in patients of acquired immune deficiency syndrome (AIDS).

METHODS:

A case series.

RESULTS:

A detailed clinical examination and systemic review of all the three patients on HAART was performed. While one manifested with the more severe variant of TEN, two of these patients presented with SJS with ocular involvement. Despite withdrawal of nevirapine, the ocular surface disorder persisted. The entailing chronic epitheliopathy along with the compromised immune status led to the development of secondary microbial keratitis in all these cases.

CONCLUSIONS:

The immune reconstitution occurring as a response to the antiretroviral therapy may potentially increase immunologically mediated diseases like SJS and TEN, which in turn may predispose the eye to develop corneal ulcer.

• Authors: Ritika Sachdev, Shubha Bansal, Rajesh Sinha, Namrata Sharma, Jeewan S Titiyal
• Journal: Ocular immunology and inflammation (Ocul Immunol Inflamm) Vol. 19 Issue 5 Pg. 343-5 (Oct 2011) ISSN: 1744-5078 [Electronic] England
• PMID: 21834698 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Aza Compounds
• Benzamidines
• Fluoroquinolones
• Quinolines
• Tropanes
• propamidine isethionate
• homatropine
• Cefazolin
• Carboxymethylcellulose Sodium
• chlorhexidine gluconate
• Chlorhexidine
• Moxifloxacin
• Tobramycin

Topics

• Acquired Immunodeficiency Syndrome (drug therapy)
• Adult
• Amnion (transplantation)
• Anti-Bacterial Agents (therapeutic use)
• Antiretroviral Therapy, Highly Active (adverse effects)
• Aza Compounds (therapeutic use)
• Benzamidines (therapeutic use)
• Carboxymethylcellulose Sodium (therapeutic use)
• Cefazolin (therapeutic use)
• Chlorhexidine (analogs & derivatives, therapeutic use)
• Corneal Ulcer (chemically induced, drug therapy, microbiology, surgery)
• Drug Therapy, Combination
• Fluoroquinolones
• Humans
• Male
• Middle Aged
• Moxifloxacin
• Pain (chemically induced, microbiology)
• Quinolines (therapeutic use)
• Stevens-Johnson Syndrome (chemically induced, microbiology)
• Tobramycin (therapeutic use)
• Treatment Outcome
• Tropanes (therapeutic use)
• Visual Acuity (drug effects)