Herpes simplex keratitis

Topic Completed: 1 October 2013

Minor changes: 24 December 2020

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PubMed Search: Herpes simplex keratitis [title] pathology

Nat Pernick, M.D.
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Cite this page: Pernick N. Herpes simplex keratitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyecorneaHSVkeratitis.html. Accessed January 22nd, 2021.
Definition / general
  • Most common cause of corneal ulcers
  • Usually unilateral, may recur
  • Usually HSV1
  • Difficult in recurrent cases
  • May need EM, PCR, ISH or immunohistochemistry since cultures are usually negative and inclusions are rarely identified
Microscopic (histologic) description
  • Diffuse epithelial edema causing bullae between epithelium and Bowman layer
  • Also patchy loss of Bowman layer
  • Irregular epithelium
  • Infiltration of anterior stroma by lymphocytes and plasma cells with stromal fibrosis and neovascularization
  • Severe cases have granulomatous reaction surrounding Descemet membrane
  • Herpetic inclusions are rare
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