Delayed-onset Bilateral Peripheral Posterior Interstitial Keratitis Associated with Epstein-Barr Virus-Induced Infectious Mononucleosis

Ocul Immunol Inflamm. 2022 Feb 17;30(2):290-293. doi: 10.1080/09273948.2020.1811351. Epub 2020 Sep 18.

Abstract

Introduction: Epstein-Barr Virus (EBV) has been previously reported to cause rare occurrence of mostly epithelial and nummular keratitis. We hereby report two patients developing bilateral peripheral deep interstitial keratitis following EBV-related infectious mononucleosis (IM).

Description of cases: Two female adolescents presented with findings of chronic relapsing posterior interstitial keratitis with neovascularisation mostly located in the superior and inferior peripheral cornea, in absence of signs of anterior uveitis. The disease presented months after the occurrence of IM. Other etiologies of interstitial keratitis were excluded. EBV DNA could not be detected in the aqueous humor of both patients. The patients responded promptly to topical corticosteroids, with multiple recurrences reported in one case.

Conclusion: EBV-induced IM can cause bilateral peripheral interstitial keratitis with delayed onset. Progressive relapsing course of the keratitis can be observed.

Keywords: Epstein-Barr Virus (EBV); Keratitis; infectious mononucleosis.

MeSH terms

  • Adolescent
  • Cornea
  • Epstein-Barr Virus Infections* / complications
  • Epstein-Barr Virus Infections* / diagnosis
  • Epstein-Barr Virus Infections* / drug therapy
  • Female
  • Herpesvirus 4, Human / genetics
  • Humans
  • Infectious Mononucleosis* / complications
  • Infectious Mononucleosis* / diagnosis
  • Keratitis* / diagnosis
  • Keratitis* / drug therapy
  • Keratitis* / etiology