Human Herpesvirus 6-Associated Unilateral Panuveitis Mimicking Endogenous Endophthalmitis in a Case with Ulcerative Colitis: Report of a Case and Literature Review.

Abstract

Purpose: To present a rare case of panuveitis caused by Human herpesvirus 6 (HHV-6), initially misdiagnosed as endogenous endophthalmitis.

Methods: Case report.

Results: A 41-year-old woman with ulcerative colitis was admitted to us with pain in the right eye. Slit-lamp biomicroscopy of the right eye revealed an ecchymotic and edematous upper eyelid with two papular lesions, diffuse conjunctival hyperemia, severe corneal edema, and dense anterior chamber fibrinous exudation. Left anterior segment was normal. Intraocular pressure was 35 mmHg in the right eye and 15 mmHg in the left eye. Right fundus could not be visualized and B scan ocular ultrasound exhibited an attached retina with dense vitreous echogenicity. A skin biopsy was obtained from the affected eyelid, and vitreous samples were collected via single port dry vitrectomy. As endogenous endophthalmitis could not be ruled out, prophylactic intravitreal vancomycin, ceftazidime, and amphotericin B were administered at the end of the procedure. Following comprehensive clinical evaluation, HHV-6 DNA was detected via PCR analysis of the vitreous sample. The patient was treated with systemic acyclovir, leading to the gradual resolution of the anterior segment inflammation.

Conclusion: Present case highlights the importance of including HHV-6 infection in the differential diagnosis of ocular inflammation and emphasizes its ocular features.