A 7-year-old child has had worsening performance in school for the past 4 months from decreased vision. Examination of the right eye shows diffuse punctate inflammation of the cornea and pannus extending as growth of fibrovascular tissue from conjunctiva onto the cornea. Microscopic examination of a corneal scraping shows lymphocytes, plasma cells, neutrophils, and scattered corneal epithelial cells that have cytoplasmic inclusion bodies. Which of the following infectious agents is most likely to produce these findings?
Trachoma is a major cause of blindness worldwide. The initial inflammation from infection is followed by progressive conjunctival scarring with eyelid involvement so that the eyelashes turn inward (trichiasis) to produce scarring of the conjunctiva and cornea. In children, cytomegalovirus (CMV), one of the herpesviruses, is a rare cause of ocular infection. CMV produces prominent intranuclear inclusions. Herpetic keratitis can result in ulceration and scarring; herpesviruses have intranuclear inclusions. Congenital rubella, which is now a rare disease because of immunization, produces retinopathy. Congenital infections with Treponema pallidum result in interstitial keratitis.
Chlamydia trachomatis
Cytomegalovirus
Herpes simplex virus
Rubella virus
Infectious Disease