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Eur J Pediatr (2009) 168:11251128 DOI 10.1007/s00431-008-0878-8
SHORT REPORT
Acute retinal necrosis caused by herpes simplex virus type 2 in a 3-year-old Japanese boy
Naoko Tanaka-Kitajima & Naomi Iwata &
Yoshihiro Ando & Hiroko Sakurai & Mio Iwami &
Kin-ichi Tsuzuki & Mineo Kondo & Yoshinori Ito &
Hiroshi Kimura
Received: 15 August 2008 /Accepted: 4 November 2008 /Published online: 3 December 2008 # Springer-Verlag 2008
Abstract Acute retinal necrosis (ARN), which is characterized by rapidly progressing peripheral retinal necrosis, is caused mainly by herpes simplex virus type 1, herpes simplex virus type 2 (HSV-2), or varicella-zoster virus. A previously healthy 3-year-old Japanese boy developed ARN in his left eye after being bruised by a milk container. HSV-2 DNA was detected in the aqueous humor of the affected eye. Serological testing suggested that the route of infection was from mother to child, although there was no past history of apparent HSV-2 infection. Childhood ARN has not been previously reported in Japan, possibly because of the low seroprevalence of HSV-2 in Japanese women.
Pediatricians must be aware of this rare disease, which can affect individuals without a previous history of HSV even in a country with a low seroprevalence of HSV-2.
Keywords Acute retinal necrosis . Herpes simplex virus . HSV-2 . Neonatal herpes
Introduction
Acute retinal necrosis (ARN), which was first described in 1971 by Urayama et al. [4], is a rare disease that is caused mainly by herpes simplex virus (HSV) or varicella-zoster virus (VZV), although cytomegalovirus and EpsteinBarr virus infections occasionally lead to ARN. The majority of ARN cases occur in immunocompetent adults. Symptoms include the rapid progression of peripheral retinal necrosis, retinal arteritis, and prominent inflammatory reactions in the anterior chamber and vitreous [4]. Although the pathogenesis of ARN has not been definitively determined, most cases are thought to be caused by the reactivation of a latent herpes virus infection.
Acute retinal necrosis can also occur in children, teenagers, and young adults; however, the majority of these cases are caused by herpes simplex virus type 2 (HSV-2 ARN) [1, 10, 15]. Here, we present the case of a 3-year-old boy with ARN that was caused by HSV-2. To the best of our knowledge, this is the earliest definitive report of HSV-2 ARN....