Infection of the corneal endothelium in herpes simplex keratitis

PURPOSE: To describe viral infection of the corneal endothelium in a patient with recurrent herpes simplex virus keratitis in the corneal graft. METHODS: Case report. A healthy 28-year-old man presented with necrotizing stromal keratitis and corneal perforation in the corneal graft. A second penetrating keratoplasty was performed. The corneal button was processed for histopathologic, immunohistochemical, and electron microscopic studies. RESULTS: Histopathologically, the corneal endothelium showed viral inclusion bodies. Herpes simplex virus antigens and viral particles were identified in stromal keratocytes and corneal endothelial cells, CONCLUSION: Productive herpes simplex virus infection of the corneal endothelial cells may contribute to corneal graft failure in recurrent herpes simplex virus infections. (Am J Ophthalmol 1998;126:592-594; (C) 1998 by Elsevier Science Inc, All rights reserved.).