A 45-year-old man with a history of recurrent cold sores presents with severe blepharitis, conjunctivitis, and corneal dendritic ulcers confirmed by fluorescein staining. He has been applying topical corticosteroids to his eye for 3 weeks without improvement. His lesions are now worsening with deeper stromal involvement. Which of the following best explains the paradoxical worsening of his condition?
- A)Corticosteroids cross the blood-brain barrier and inhibit trigeminal ganglia immune responses
- B)Topical corticosteroids suppress local immune responses, allowing deeper viral invasion and stromal inflammationGABARITO
- C)Corticosteroids promote epithelialization, which traps virus beneath healing epithelium
- D)Prolonged corticosteroid use causes secondary bacterial superinfection of viral lesions
- E)The corticosteroid vehicle increases corneal osmolarity, causing epithelial cell death
Explicação
Topical corticosteroids are contraindicated in herpes simplex keratitis because they suppress local immune responses and T cell infiltration, paradoxically allowing deeper viral invasion and progression to stromal keratitis. This classic teaching emphasizes th... Ver explicação completa e trilha adaptativa →