Recurrence of herpes simplex keratitis after azithromycin
The article by Kumar,1 titled "Recurrence of herpes simplex keratitis after azithromycin" was interesting. However, the following point needs further clarification. The article says the patient first presented in December 2002, with herpes simplex keratitis. His symptoms started three days after taking azithromycin, which was prescribed for upper respiratory tract infection. The patient came back with the recurrence of eye disease in March 2005. This time too he received azithromycin for three days. The question is could the coexisting infection for which azithromycin was prescribed be the cause of relapse of herpes s implex keratitis? It is well known that herpes simplex keratitis relapses after an attack of febrile illness, stress, trauma, sunlight, heat and menstruation.2 So in this particular patient the relapse of herpetic keratitis cannot be totally attributed to azithromycin. To label azithromycin as the triggering factor, the patient should have received azithromycin challenge and observed for the relapse of herpes Simplex keratitis. Hope the author will clarify the point.
1. Kumar S. Recurrence of herpes simplex keratitis after azithromycin Indian J Ophthalmol. 2007;55:84–5
© 2007 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow
2. Araffa RC Grayson's diseases of the cornea. 19913rd ed Published by Mosby Year Book:240