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Case Study: January 2014
History
- 55 year old man with a history of chronic keratitis.
- Develops a corneal ulcer and then perforates the cornea over a matter of a few days.
- Evisceration performed.
- Sections show cornea sections only (Fig 1 and 2).
Questions
- Which distinctive features are seen on Fig 2?
- What is the likeliest diagnosis?
- Which further tests can be performed on this tissue to confirm the diagnosis?
Click to show answers
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- The corneal epithelium shows cells with intranuclear, grey viral inclusions.
- The H&E diagnosis is that of herpes simplex keratitis.
- HSV immunohistochemistry-see fig 3. it was positive in the same area as the epithelial nuclear inclusions. Can also do PCR on paraffin sections and if required, transmission electron microscopy.
