Hypopyon keratitis as a complication of primary varicella in a 7-month-old child

Abstract

Ocular complications associated with primary varicella zoster virus infection may involve any part of the eye. Unlike ophthalmic zoster in which the virus reactivates, ocular complications from primary varicella are rare. The aim is to present an interesting clinical case of a primary varicella keratitis overlapped by a bacterial infection. A seven-month old boy was presented to an outpatient clinic 10 days (about 1 and a half weeks) after the beginning of a chickenpox rash with symptoms of bacterial keratitis of his right eye. He was admitted to a specialized clinic and successfully treated with a combination of topical quinolone treatment, washing of the conjunctival sac with iod-povidone 5% and two subconjunctival applications of Cefotaxime 5% and Atropine/Adrenalin 1% under general anesthesia. Twenty days after the initial complaints there were no signs of inflammation and only two small macules could still be observed. The child would be followed up for three months in case of recurrence. Primary varicella, even though considered benign in childhood, should not be underestimated. Some serious ocular complications can develop which if left untreated could lead to devastating visual results.