ArticleInternational medical case reports journal2026
When Immune System and Herpes Virus Infection Collide: A Case of Severe Stromal Herpetic Keratitis in a Patient with Rheumatoid Arthritis Under Methotrexate.
Article in International medical case reports journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To report a case of refractory herpes simplex virus keratitis (HSVK) complicated by keratolysis and severe stromal thinning in a patient with rheumatoid arthritis (RA) under treatment with methotrexate (MTX). Observations: A 79‑year‑old patient with a history of HSVK and RA, treated with weekly MTX, presented with pain and photophobia in the right eye. Best‑corrected visual acuity (BCVA) was limited to counting fingers. Slit‑lamp examination revealed a supero-nasal corneal ulcer (area of 2.98 mm Conclusion and Importance: This case underscores how systemic immunomodulatory treatment may play a clinically relevant role in patients with recurrent HSVK. In selected cases, a conservative, surgery‑sparing approach through the optimization of systemic therapy can help promoting viral load control and corneal healing.
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