Hydrocortisone Acetate/Neomycin sulfate

A 29-year-old mechanical engineer was seen in the Yale-New Haven Emergency Room with painful eyes, malaise, chills and fever. Five days prior to admission, a small quantity of turpentine had splashed into his left eye while he was wear­ ing a contact lens. The patient irrigated his left eye with water but did not see a physician until four days later, when his local physician pre­ scribed Neo-Cortef for a red, tearing, itching and burning left eye. The left eye felt better for 24 hours, then became painful, swollen and red, and the right eye felt irritated. A fever de­ veloped, malaise progressed and the patient came to the hospital. The patient had no prior similar disease. Mul­ tiple previous episodes of fever blisters had oc­ curred. ' Positive physical findings were fever of 103°F, a tender left preauricular lymph node and gen­ eralized cervical adenopathy. Several 2 to S-mm vesicles and open crusted lesions on an erythematous base were present on the nose, forehead and both eyelids. A vesicle was noted at the left angle of the mouth. Eye findings included: vision, R.E., 20/70; L.E., 20/60-2. The eyelids were swollen, lid mar­ gins were ulcerated, and the conjunctivas were edematous and injected (fig. 1). There was a clear watery discharge bilaterally. Both corneas showed nonspecific punctate epithelial staining pe­ ripherally and centrally. The remainder of the eye examination was normal. The patient was treated with Chloromycetin eyedrops for 24 hours. The next day, the eye findings were unchanged but, because of increased general malaise, he was admitted to the hospital. At this time additional pustular lesions of different ages were noted on both thighs. With a presumptive diagnosis of herpes simplex kerato­ conjunctivitis in a patient with generalized herpes, the patient was started on idoxuridine to the left eye and iodoxuridine soaks to the skin lesions of the left eyelid. The right eye was treated with Chloromycetin only. Two days after