Nasopharyngeal 13-virus PCR panel for the rapid diagnosis of adenovirus corneal ulcer in an infant: A case report and literature review
Abstract
Rationale: Infantile corneal ulcer is a sight-threatening emergency, with bacterial and traumatic causes being common. Adenovirus (ADV), especially species D, is an under-recognized pathogen in infants. Corneal scraping is often infeasible in this age group, necessitating alternative diagnostic approaches.
Patient concerns: A 5-month-old full-term twin presented with bilateral photophobia, conjunctival redness, and mucopurulent discharge lasting 10 days. Hand-held slit-lamp examination revealed pseudomembranous conjunctivitis and bilateral shield corneal ulcers measuring 6.7 mm.
Diagnoses: Corneal culture was negative, and parental consent for scraping was withheld. A nasopharyngeal swab was tested using a 13-virus multiplex real-time polymerase chain reaction panel for viruses, which detected ADV subtype D within 4 hours, confirming the diagnosis of ADV-induced keratitis.
Interventions: Treatment comprised topical acyclovir eye drops (8 times/day) combined with levofloxacin gel (3 times/day), along with mechanical removal of pseudomembranes.
Outcomes: Complete corneal reepithelialization was achieved within 14 days, with no residual sequelae.
Lessons: Nasopharyngeal 13-virus multiplex polymerase chain reaction offers a minimally invasive, rapid, and reliable diagnostic alternative for infantile adenoviral keratitis when corneal sampling is not feasible.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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