PRIMARY VARICELLA-ZOSTER KERATITIS - DIAGNOSIS BY POLYMERASE CHAIN-REACTION

PURPOSE: To report the value of polymerase chain reaction in the diagn osis of a worsening corneal ulcer. METHODS: A 6-year-old boy underwent an emergent penetrating keratoplasty for a corneal ulcer that continu ed to worsen despite intensive antibiotic therapy. RESULTS: Examinatio n of the corneal specimen by polymerase chain reaction was positive fo r varicella-zoster virus but negative for herpes simplex. Based on pol ymerase chain reaction studies, we diagnosed primary varicella-zoster keratitis with corneal perforation. Electron microscopy showed herpeti c virus particles in the cornea. CONCLUSIONS: Polymerase chain reactio n analysis of corneal buttons at the time of penetrating keratoplasty may benefit patients with undiagnosed recalcitrant corneal ulcers.