Case Report Herpetic Meibomianitis : an Unusual Case Report

Herpes simplex virus (HSV) infection of the eye can vary from mild blepharitis to sight threatening choreoretinitis. Primary infection of the eye is usually sub-clinical but reactivation of a latent infection can lead to recurrent disease. Although, herpetic blepharitis is a well documented entity, this virus has so far not been incriminated in the causation of meibomianitis, an inflammatory condition of the meibomian gland. This paper reports a case of meibomianitis due to Herpes simplex virus. HERPETIC MEIBOMIANITIS Vol 38 No. 3 May 2007 467 0.5% fetal calf serum; 0.3 ml of the sample was inoculated in Vero cell culture tubes and rest 0.2 ml was used for viral DNA extraction by Qiagen DNA extraction kit (Qia Amp, Germany) and further demonstration of HSV DNA by polymerase chain reaction using 20 bp primers 5 ́ATC AAC TTC GAC TGG CCC TT3 ́ and 5 ́CCG TAC ATG TCG ATG TTC AC3 ́ which code for the DNA polymerase gene (Madhavan et al, 1999). The amplified product was visualized in a UV transilluminator using 2% ethidium bromide staining. Smears were made from the other swab on specially prepared immunofluoroscent slides and were stained by indirect immunofluoroscence using 1:5 diluted mouse monoclonal type speci f ic HSV-1 and -2 IgG ant ibody (NCl, Novocastra, Germany) separately and 1:8 diluted sheep antimouse FITC conjugated antibody (NCl, Novocastra,Germany) (Kalra et al, 2005). The smear stained with modified MayGraunwald Giemsa revealed multinucleated giant cells with ground glass appearance. The smears made from the inoculated Vero cells on the 5th post-inoculation day with cytopathic effects (CPE) as well as from direct sample revealed intranuclear brilliant apple green fluorescence (2-3+) against HSV-1 only. PCR analysis revealed an amplified product of 179 bp DNA polymerase gene visualized as a distinct band comparable with a known positive control. Thus, the viral isolate was characterized as HSV-1. No bacteria were isolated on culture. The patient was treated with topical acyclovir (3%) 5 times a day for one week. Clinical recovery was observed with follow-up samples negative for virus isolation and viral antigen.