Hutchinson's sign as a marker of ocular involvement in HIV-positive patients with herpes zoster ophthalmicus

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dc.contributor.authorVan Dyk, M.
dc.contributor.authorMeyer, D.
dc.date.accessioned2011-03-18T14:56:51Z
dc.date.available2011-03-18T14:56:51Z
dc.date.issued2010
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. A positive Hutchinson's sign indicates an increased risk of ocular involvement in herpes zoster ophthalmicus (HZO). We examined the sensitivity of Hutchinson's sign as an indicator of ocular involvement in a consecutive series of patients presenting with HZO. Methods. We conducted a descriptive observational prospective study of patients ≥18 years old presenting with HZO and consenting to pre- and post-test counselling and HIV and CD4 testing. A full ophthalmological examination focused on the extent of ocular involvement, and the presence of Hutchinson's sign was confirmed by two clinicians. Results. Thirty-three patients were enrolled; 29 were HIV positive, of whom 18 (62%) had not been diagnosed with HIV prior to enrolment. Of the 29 HIV-positive patients, 21 (72%) were Hutchinson's sign positive (HSP), all of whom had intra-ocular involvement (95% confidence interval 88 - 100%). Of the 8 HIV-positive, Hutchinson's sign-negative (HSN) patients, 4 did and 4 did not display intra-ocular involvement. Neither the mean CD4 count nor the average age in the HSP group differed significantly from the HSN group. Conclusion. We confirmed that a Hutchinson's sign- and HIVpositive patient with HZO has a very high positive predictive value for intra-ocular involvement. Neither age nor CD4 count had predictive value for ocular involvement. Young adults presenting with HZO should be suspected of having HIV, and HIV-positive patients with HZO but HSN may still have ocular involvement. All patients with HZO should be seen by an ophthalmologist.en_ZA
dc.description.versionPublishers' version
dc.format.extentp. 172-174
dc.identifier.citationVan Dyk, M. & Meyer, D. 2010. Hutchinson's sign as a marker of ocular involvement in HIV-positive patients with herpes zoster ophthalmicus. SA Medical Journal. 100(3), 172-174, http://www.samj.org.za/index.php/samj
dc.identifier.issn0256-9574 (print)
dc.identifier.issn2078-5135 (online)
dc.identifier.urihttp://hdl.handle.net/10019.1/7022
dc.language.isoen_ZA
dc.publisherHealth and Medical Publishing Group (HMPG)
dc.rights.holderHealth and Medical Publishing Group (HMPG)
dc.subjectHerpes zoster ophthalmicusen_ZA
dc.subjectHutchinson’sen_ZA
dc.subjectHIV infectionsen_ZA
dc.titleHutchinson's sign as a marker of ocular involvement in HIV-positive patients with herpes zoster ophthalmicusen_ZA
dc.typeArticle
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