A man with acquired immunodeficiency syndrome developed a generalized
rash and bilateral dendritic epithelial keratitis without retinitis. C
ytologic examination of superficial corneal scrapings showed many mega
losyncytial giant cells that were highly characteristic of cytomegalov
irus (CMV) infection. Viral cultures yielded CMV from 2 separate speci
mens obtained by corneal epithelial debridement from both eyes. The sl
ightly elevated, opaque, branching, nonulcerative epitheliopathy recur
red after corneal scrapings and persisted despite oral and topical ant
iviral therapy. Stromal keratouveitis subsequently developed. This cas
e report confirms that CMV can produce corneal involvement and suggest
s that CMV keratitis may be an emergent complication of acquired immun
odeficiency syndrome.