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Nakul Katyal, Ather M Taqui, Deborah Tepper, Jonathan M Beary, Christopher R Newey
Herpes simplex-1 virus encephalitis (HSE) is the most commonly recognized cause of sporadic encephalitis in the United States. Historically HSE has been considered extremely detrimental given the associated relentless neurological deterioration secondary to cerebral edema and status epilepticus. With recent advances in antiviral therapeutics in past decades, the majority of complications can be managed effectively although the associated morbidity and mortality still remains high. The key modifiable factor determining recovery is the rapid initiation of antiviral therapy...
April 12, 2018: Curēus
Kimiyasu Shiraki
The discovery of acyclovir and penciclovir has led to the development of a successful systemic therapy for treating herpes simplex virus infection and varicella-zoster virus infection, and the orally available prodrugs, valacyclovir and famciclovir, have improved antiviral treatment compliance. Acyclovir and penciclovir are phosphorylated by viral thymidine kinase and are incorporated into the DNA chain by viral DNA polymerase, resulting in chain termination. Helicase-primase plays an initial step in DNA synthesis to separate the double strand into two single strands (replication fork) and is a new target of antiviral therapy...
2018: Advances in Experimental Medicine and Biology
Jun-Ichi Kawada
Herpes simplex virus (HSV) encephalitis is the most common cause of sporadic fatal encephalitis worldwide, and central nervous system (CNS) involvement is observed in approximately one-third of neonatal HSV infections . In recent years, single-gene inborn errors of innate immunity have been shown to be associated with susceptibility to HSV encephalitis . Temporal lobe abnormalities revealed by magnetic resonance imaging-the most sensitive imaging method for HSV encephalitis-are considered strong evidence for the disease...
2018: Advances in Experimental Medicine and Biology
Irene Tsappa, Constantinos Missouris, Savvas Psarellis
Acyclovir has been used in the treatment of herpes simplex and varicella zoster viral infections for over 30 years. The side effects of oral treatment at standard doses are rare and include headache, diarrhoea, dizziness and malaise. We report a patient with a new diagnosis of systemic lupus erythematosus (SLE) who developed thrombocytopaenia within days on a therapeutic dose with acyclovir. Prompt discontinuation of acyclovir and treatment with intravenous immunoglobulin resulted in reversal of the above potentially serious complication...
June 8, 2018: BMJ Case Reports
Ljiljana Djekic, Jovana Janković, Aleksandar Rašković, Marija Primorac
Semisolid self-microemulsifying drug delivery system (SMEDDS) with optimized drug loading capacity, stability, dispersibility in aqueous media and in vitro drug release profile, was evaluated in vivo regarding effects on pharmacokinetics of acyclovir, an antiviral with low bioavailability (BA) and short half-life (t1/2 ). Additional goal of this study was evaluation of safety of this semisolid SMEDDS consisted of medium chain length triglycerides (oil) (10% w/w), macrogolglycerol hydroxystearate (surfactant) (56...
June 5, 2018: European Journal of Pharmaceutical Sciences
Natalia V Motorna, Svetlana L Rybalko, Daria B Starosyla, Mykhailo M Guzyk, Iryna G Strokina, Rostyslav F Kaminsky, Alina V Korsak, Sergey I Savosko, Liudmyla M Sokurenko, Yurii B Chaikovsky
OBJECTIVE: Inrtoduction: Post-stroke complications are one of the urgent and insufficiently resolved problems. According to different literature data 23% to 65% of patients suffer from the post-stroke development of an infectious process. Herpes simplex virus type 1 and 2 can also be etiological factors of stroke development, however their reactivation is seldom mentioned in clinical observations. The development of immune suppression is considered to be the cause of these complications...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Takashi Yoshimura, Tatsuya Kawasaki, Ayumi Shirota, Masashi Saeki, Yuki Okada, Hiroshi Okada
Valacyclovir, a prodrug of acyclovir, is the first-line treatment for herpes zoster, but the renal function must be monitored, because acyclovir is metabolized by the kidneys. We herein report a case of valacyclovir-induced neurotoxicity with no preceding renal impairment. An 88-year-old man was admitted because of an impaired consciousness after the administration of valacyclovir at 3,000 mg daily for herpes zoster on the chest. His consciousness level gradually improved with hydration and valacyclovir withdrawal...
June 6, 2018: Internal Medicine
Marija Kusulja, Marija Santini
Herpes simplex encephalitis is a rare disease with significant morbidity and mortality, although targeted therapy is widely available. We present two cases of herpes simplex encephalitis in previously healthy, young adults treated with acyclovir who developed severe brain edema. Decompressive craniectomy prevented imminent brain herniation and fatal outcome in both our patients.
June 2, 2018: International Journal of Infectious Diseases: IJID
Cristina Tintori, Giulia Iovenitti, Elisa Rita Ceresola, Roberto Ferrarese, Claudio Zamperini, Annalaura Brai, Giulio Poli, Elena Dreassi, Valeria Cagno, David Lembo, Filippo Canducci, Maurizio Botta
Although highly active antiretroviral therapies (HAART) remarkably increased life expectancy of HIV positive people, the rate of novel HIV-1 infections worldwide still represent a major concern. In this context, pre-exposure prophylaxis (PrEP) approaches such as vaginal microbicide gels topically releasing antiretroviral drugs, showed to have a striking impact in limiting HIV-1 spread. Nevertheless, the co-presence of other genital infections, particularly those due to HSV-1 or 2, constitute a serious drawback that strongly limits the efficacy of PrEP approaches...
2018: PloS One
Constance N White, Gareth Jones, Sarah Baker, Rachel S Dean, Marnie L Brennan
Treatment variation in medicine may be driven by evidence gaps, clinician factors, and patient preferences. Although well-documented in human medicine, variation in clinical management is relatively unexplored in veterinary practice. Clinical vignette questionnaires were administered to a cross section of general practitioners (GPs) and veterinarians with postgraduate training in ophthalmology (PGs) to survey recommended management of canine prolapsed nictitans gland ("cherry eye", PNG) and feline herpesvirus (FHV-1) keratitis...
June 1, 2018: Veterinary Sciences
Nesreen A Faqih, Mahmoud A Alfaqih, Khadra Salami, Brian Herron, Iyad Sultan, Maysa Al-Hussaini
Introduction: Hepatitis secondary to Herpes Simplex Virus (HSV) infection is a complication that often leads to fatal hepatic failure. Early treatment with the anti-viral drug, acyclovir, is life-saving. In view of the non-specific nature of the signs and symptoms associated with HSV hepatitis, diagnosis is often made late during the course of the disease; a factor that largely contributes to the high mortality rate of this treatable disease complication. There is thus a growing consensus in the field to initiate empirical treatment with acyclovir once suspicion of HSV hepatitis is raised even before reaching a conclusive diagnosis...
2018: IDCases
Takuya Inagaki, Masaaki Satoh, Hikaru Fujii, Souichi Yamada, Miho Shibamura, Tomoki Yoshikawa, Shizuko Harada, Haruko Takeyama, Masayuki Saijo
Several cases of herpes simplex encephalitis (HSE) caused by acyclovir (ACV)-resistant herpes simplex virus type 1 (HSV-1) have been reported. Amino acid substitutions of R41H, Q125H, and A156V in the viral thymidine kinase (vTK) gene were reported to confer ACV-resistance. Recombinant HSV-1 clones with each amino acid substitution in the vTK were generated using the bacterial artificial chromosome (BAC) system. A recombinant HSV-1 with the substitution of Q125H showed ACV-resistance, while those of R41H or A156V were sensitive to ACV...
May 31, 2018: Japanese Journal of Infectious Diseases
Kate E Alexander, Philip L Tong, Kristine Macartney, Rohan Beresford, Vicky Sheppeard, Monisha Gupta
In 2016, the live attenuated zoster vaccine (Zostavax, Merck and Co, USA) was introduced into the Australian National Immunisation Program for people aged 70 years who are not significantly immunocompromised. We report the administration of Zostavax in an immunocompromised patient with chronic lymphocytic leukaemia and no evidence of primary varicella zoster virus (VZV) infection. The patient presented with a bilateral vesicular facial rash 22 days after receiving Zostavax and was initially managed as an outpatient with oral acyclovir...
May 25, 2018: Vaccine
Magdalena Siodlak, Margaret R Jorgenson, Jillian L Descourouez, Glen E Leverson, Didier A Mandelbrot, Jeannina A Smith, Robert R Redfield
STUDY OBJECTIVE: To evaluate the clinical course and long-term impact of high-dose acyclovir (HD-A, 800 mg 4 times daily) cytomegalovirus (CMV) prophylaxis failure in a CMV- seropositive abdominal solid organ transplant population. DESIGN: Retrospective cohort study. SETTING: Tertiary academic medical center. PATIENTS: A total of 691 adults who received solid organ transplants between January 1, 2008, and June 30, 2013, without lymphocyte-depleting induction and were prescribed 3 months of HD-A prophylaxis at the time of hospital discharge; of those patients, 54 experienced prophylaxis failure, defined as CMV detected via molecular diagnostics or on biopsy while receiving HD-A (prophylaxis failure group), and 637 did not (comparator group)...
May 25, 2018: Pharmacotherapy
Tine Vestergaard
Genital herpes is a common sexually transmissible infection (STI) caused by herpes simplex virus (HSV). Clinically, the infection presents with genital ulcers but may also be asymptomatic. The risk of genital HSV infection is associated with increasing number of sex partners, previous infection with another STI and female sex. The cornerstone of treatment is systemic antivirals such as acyclovir. Counselling on transmission and recurrence risks is essential, and psychological distress is often a consequence of the disease...
May 14, 2018: Ugeskrift for Laeger
Naama Pines, Reuven Tsabari, Eitan Kerem, Joel Reiter
Herpes simplex virus (HSV) is rarely the cause of pneumonia in immunocompetent patients. We describe a previously healthy child, with no evidence of an immunodeficiency, who presented to the emergency department with severe pneumonia, wheezing, and pleural effusions with a history of orolabial HSV infection. On admission, he was started on antibiotics and systemic corticosteroids but continued to deteriorate. Oral lesions, blood, and pleural fluid tested positive for HSV, and improvement was achieved only after the addition of acyclovir and discontinuation of steroids...
May 23, 2018: Pediatric Emergency Care
Marielle Lebrun, Julien Lambert, Laura Riva, Nicolas Thelen, Xavier Rambout, Caroline Blondeau, Marc Thiry, Robert Snoeck, Jean-Claude Twizere, Franck Dequiedt, Graciela Andrei, Catherine Sadzot-Delvaux
ORF9p (homologous to HSV-1 VP22) is a varicella-zoster virus (VZV) tegument protein essential for viral replication. Even though its precise functions are far from being fully described, a role in the secondary envelopment of the virus has long been suggested. We performed a yeast two-hybrid screen to identify cellular proteins interacting with ORF9p that might be important for this function. We found thirty-one ORF9p interaction partners, among which AP1M1, the μ subunit of the adaptor protein complex-1 (AP-1)...
May 23, 2018: Journal of Virology
Aarthy Uthayakumar, David Harrington
BACKGROUND: Primary varicella zoster virus (VZV) infection is a common illness, predominantly affecting children. Its course is typically benign, although severe complications have been described. Splenic rupture is an extremely rare and potentially fatal complication of primary VZV infection, with only a handful of cases reported in the literature. CASE PRESENTATION: A 32-year-old Romanian man with no significant past medical history, presented with a 2 day history of sudden onset, worsening generalised abdominal pain and a 1 day history of vomiting...
May 22, 2018: BMC Research Notes
Antigona Begolli Gerqari, Mybera Ferizi, Merita Kotori, Aferdita Daka, Syzana Hapciu, Ilir Begolli, Mirije Begolli, Idriz Gerqari
Tattooing is a procedure where ink is applied to an area of the skin, mostly intraepidermally (1). This procedure is carried out mainly for aesthetic purposes. Lately, it has been used as a corrective medical procedure following amputation of mammilla. The procedure is aggressive (2), and the fact that skin is punctured many times with the same needle which cannot be fully sterilized may cause infection of the treated area with bacterial, fungal, or viral agents that may lead to health consequences manifesting in the form of verrucae vulgaris, molluscum contagiosum, and herpes simplex...
April 2018: Acta Dermatovenerologica Croatica: ADC
María A Vissani, Osvaldo Zabal, María S Tordoya, Viviana Parreño, Etienne Thiry, María Barrandeguy
Equid alphaherpesvirus 3 (EHV3) is the etiological agent of equine coital exanthema (ECE), which is a venereal, highly contagious disease, characterized by the formation of papules, vesicles, pustules and ulcers on the external genitalia of mares and stallions. EHV3 remains in a latent state after a successful infection and there are latently infected animals in which the virus is reactivated and generally re-excreted subclinically. There are no available vaccines for this condition and prevention is based on the clinical examination of mares prior to mating, which allows to segregate those showing clinical signs...
May 17, 2018: Revista Argentina de Microbiología
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