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Herpes Zoster Ophthalmicus — SCE Infectious Diseases MCQ

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HardImmunocompromised HostHerpes Zoster OphthalmicusSCE Infectious Diseases

A renal-transplant recipient taking tacrolimus has ophthalmic zoster with V1 vesicles, conjunctivitis, fever and lesions outside the primary dermatome. What is the best initial treatment?

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Correct answer: B — Intravenous aciclovir about 10 mg/kg every 8 hours with renal adjustment, hydration and urgent ophthalmology input

The best answer is “Intravenous aciclovir about 10 mg/kg every 8 hours with renal adjustment, hydration and urgent ophthalmology input”. Disseminated zoster with ophthalmic involvement in a renal-transplant recipient requires intravenous aciclovir, with renal adjustment, hydration and urgent ophthalmology input. Oral antivirals and topical aciclovir alone are insufficient in this high-risk presentation, while steroid eye drops without systemic antiviral treatment may worsen infection.

Reference: Aciclovir IV SmPC: https://www.medicines.org.uk/emc/product/377/smpc