Pathology: ocular herpes

ocular herpes  

A middle aged female 3 years post liver transplant presented to the hospital with a similar ocular finding to the one in the image above.  She was leukopenic.  Ocular herpes was diagnosed. There was involvement of the central nervous system as well (meningoencephalitis).  The patient was treated with acyclovir 250 mg IV daily.  On days of dialysis (for an unrelated renal failure), the drug was given after dialysis.

Ocular herpes (and the aural presentation, ie. Ramsay Hunt syndrome) are opportunistic infections in the immunocompromised patient.  In this case, a patient with a liver transplant who was on mycophenolate mofetil and sirolimus.  A cutaneous presentation will have the typical vesicular presentation, but remember that there can be disseminated disease with involvement of organs like the CNS or the liver.

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