Adenovirus epithelial keratitis

The authors sought to determine whether adenovirus could infect human corneal epithelium in vivo. They reviewed the medical records of six patients with adenovirus-positive vital corneal cultures who were examined at the Bascom Palmer Eye Institute between March 21, 1986, and December 31, 1992. The six patients with adenovirus-positive vital corneal cultures included one patient with dendritic epithelial keratitis, one with geographic epithelial ulceration, three with both geographic ulceration and contiguous dendrites, and one with heaped-up corneal epithelium but no ulceration. Four patients had rose bengal solution applied to their ocular surface, and in all four patients rose bengal uptake was seen at the epithelial edges of the dendrite or geographic ulceration in a manner characteristic of herpes simplex viral keratitis. Serotype determination of the isolates showed adenovirus type 3 (one patient), type 8 (three patients), type 19 (one patient), and indeterminate (one patient). Results of monoclonal antibody staining of cultures against herpes simplex virus (types 1 and 2) antigens was negative for all six cases. Adenovirus epithelial keratitis may result from infection of human corneal epithelium by the virus and rarely may mimic infection of corneal epithelium by herpes simplex virus.