Primary Graft Failure and Systemic Presentations of HSV Infection Following Transplantation of an HSV-Contaminated Donor Cornea

To report a case of primary graft failure (PGF) and systemic manifestations of herpes simplex virus (HSV) infection following transplantation of an HSV-contaminated donor cornea.Patient and A 28-year-old male with history of penetrating keratoplasty 12 days before, developed intraocular inflammation with marked anterior chamber reaction, graft edema and elevated intraocular pressure (IOP) together with systemic manifestations such as fever and unilateral cervical adenopathy. Systemic manifestations resolved after a few days but the graft edema was persistent. Regraft was performed after 3 months and the previous donor tissue was evaluated by PCR for cytomegalovirus (CMV) and HSV and was positive for HSV. HSV may be a cause of PGF, which can be transmitted by a contaminated donor cornea to the recipient. This condition may also lead to systemic symptoms.