Varicella Zoster Reactivation Manifesting as Serpiginous Peripheral Keratitis and Disciform Keratitis Occurring After Necrotizing Fasciitis in an Immunocompromised Male: A Case Report

Reactivation of herpes zoster ophthalmicus (HZO) can present as corneal involvement without any precedent neuralgia or characteristic herpetic rash. This form HZO be the first manifestation reactivation varicella virus and masquerade peripheral ulcerative keratitis. A 45-year-old male treated for necrotizing fasciitis (NF) one month back presented with painful diminution vision in right eye (RE) two weeks associated vesicular rash neuralgia. On examination, best-corrected visual acuity RE was 2/60 non-marginal upper lid defect, multiple linear contracture scars involving lid, temple, preauricular region. There were ring infiltrates, disc-shaped central stromal edema, reduced sensation. The patient had a history chicken pox childhood recently diagnosed seropositive rheumatoid arthritis (RA). Though scrapings negative on Tzanck smear, presumptive clinical diagnosis disciform keratitis made, started oral topical acyclovir steroids. confirmed improving course detection DNA polymerase chain reaction from scrapings. Lid reconstruction defect performed using paramedian forehead flap, which remodeled at 16 weeks. Our case, RA patient, manifesting serpiginous activated after NF. are few case reports periorbital NF following immunocompromised patients. However, till date, no occurring has been reported. Also, our