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https://www.readbyqxmd.com/read/28449377/topical-antiviral-and-antifungal-medications-in-pregnancy-a-review-of-safety-profiles
#1
REVIEW
Viral M Patel, Robert A Schwartz, William C Lambert
Medications should be employed with caution in women of childbearing age who are pregnant or considering pregnancy. Compared to oral or parenteral agents, topical medications have limited systemic absorption and are deemed safer. However, their safety profile must be assessed cautiously due to the limited available data. In this article, we aggregate human and animal studies to provide recommendations on utilizing topical antiviral and antifungal medications in pregnancy. For antiviral medications, acyclovir and trichloroacetic acid are safe to use in pregnancy...
April 27, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28420570/herpesviradae-infections-in-severely-burned-children
#2
Paul Wurzer, Megan R Cole, Robert P Clayton, Gabriel Hundeshagen, Omar Nunez Lopez, Janos Cambiaso-Daniel, Raimund Winter, Ludwik K Branski, Hal K Hawkins, Celeste C Finnerty, David N Herndon, Jong O Lee
OBJECTIVE: Burn-related immunosuppression can promote human herpesviridae infections. However, the effect of these infections on morbidity and mortality after pediatric burn injuries is unclear. METHODS: We retrospectively analyzed pediatric patients with burns ≥10% of the total body surface area (TBSA) who were admitted between 2010 and 2015. On clinical suspicion of a viral infection, antiviral therapy was initiated. Viral infection was confirmed via Tzanck smear, viral culture, and/or PCR...
April 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28417331/use-of-high-dose-oral-valacyclovir-during-an-intravenous-acyclovir-shortage-a-retrospective-analysis-of-tolerability-and-drug-shortage-management
#3
Milena M McLaughlin, Sarah H Sutton, Ashley O Jensen, John S Esterly
INTRODUCTION: In late 2011, a shortage of IV acyclovir led to the need to empirically substitute high-dose oral valacyclovir (HDVA) to conserve IV acyclovir for patients with confirmed herpes simplex virus (HSV) meningitis or encephalitis. This report describes the management of the most recent national IV acyclovir shortage by the Antimicrobial Stewardship Program (ASP) at Northwestern Memorial Hospital (NMH), Chicago, IL, USA, and the use of HDVA. Secondarily, we assessed the safety and tolerability of HDVA as an alternate to IV acyclovir during this shortage...
April 17, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28413671/paraneoplastic-limbic-encephalitis-in-a-patient-with-extensive-disease-small-cell-lung-cancer
#4
Sebastian Ochenduszko, Bartosz Wilk, Joanna Dabrowska, Izabela Herman-Sucharska, Anna Dubis, Miroslawa Puskulluoglu
Paraneoplastic limbic encephalitis (PLE) is a rare disorder infrequently accompanying malignancy, coexisting in ~50% of the cases with small-cell lung cancer (SCLC). The pathomechanism of PLE is considered to be immune-mediated, with production of specific anti-Hu antibodies and activation of T-cells directed against onconeural antigens present on both tumor cells and neurons. We herein report the case of a 50-year-old male patient who, prior to being diagnosed with SCLC, presented with typical symptoms of PLE (seizures, subacute cognitive dysfunction with severe memory impairment, anxiety and hallucinations)...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28412073/pediatric-acute-flaccid-paralysis-enterovirus-d68-associated-anterior-myelitis
#5
James A Yoder, Michael Lloyd, Luke Zabrocki, Jonathan Auten
BACKGROUND: Enteroviral infections can cause acute flaccid paralysis secondary to anterior myelitis. Magnetic resonance imaging (MRI) is important in the diagnosis of this potentially devastating pediatric disease. Before the 2014 outbreak of Enterovirus D68 (EV-D68), the virus was considered a relatively benign disease. CASE REPORT: A fully immunized 8-year-old boy was brought to the emergency department complaining of a cough, headache, neck pain, and right arm pain and weakness...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408228/new-modified-2-aminobenzimidazole-nucleosides-synthesis-and-evaluation-of-their-activity-against-herpes-simplex-virus-type-1
#6
Maria I Kharitonova, Alexandra O Denisova, Valeria L Andronova, Alexei L Kayushin, Irina D Konstantinova, Svetlana K Kotovskaya, Georgiy A Galegov, Valery N Charushin, Anatoly I Miroshnikov
Using the enzymatic transglycosylation reaction β-d-ribo- and 2'-deoxyribofuranosides of 2-amino-5,6-difluorobenzimidazole nucleosides have been synthesized. 2-Amino-5,6-difluoro-benzimidazole riboside proved to exhibit a selective antiviral activity (selectivity index >32) against a wild strain of the herpes simplex virus type 1, as well as towards virus strains that are resistant to acyclovir, cidofovir, and foscarnet. We believe that this compound might be used for treatment of herpes infections in those cases, when acyclovir is not efficient...
April 1, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28405696/-varicella-gastritis-under-immunosuppression-case-report-of-a-woman-after-lung-transplantation-due-to-granulomatosis-with-polyangiitis
#7
S Saman, J-C Henes, D Niepel, H Bosmüller, C R Werner, U M Lauer, N P Malek, T Xenitidis
A 35-year-old woman who had previously undergone a lung transplantation presented with severe abdominal pain and vomiting. The gastroscopy showed diffuse ulcerative gastric lesions. Tests for varicella zoster virus and Epstein-Barr virus via polymerase chain reactions (PCR) on endoscopically obtained gastric biopsies were found to be positive and confirmed varicella gastritis. Intravenous antiviral therapy with acyclovir was administered resulting in a normalization of all clinical symptoms, especially of abdominal pain and inflammation parameters...
April 12, 2017: Der Internist
https://www.readbyqxmd.com/read/28404842/an-immortalized-human-dorsal-root-ganglia-cell-line-provides-a-novel-context-to-study-herpes-simplex-virus-type-1-latency-and-reactivation
#8
Nikki M Thellman, Carolyn Botting, Zachary Madaj, Steven J Triezenberg
A defining characteristic of alphaherpesviruses is the establishment of lifelong latency in host sensory ganglia with occasional reactivation causing recurrent lytic infections. As an alternative to rodent models, we explored the use of an immortalized cell line derived from human dorsal root ganglia. HD10.6 cells proliferate by virtue of a transduced tetracycline-regulated v-myc oncogene. In the presence of doxycycline, HD10.6 cells mature to exhibit neuronal morphology and express sensory neuron-associated markers such as neurotrophin receptors TrkA, TrkB, TrkC, and RET and the sensory neurofilament peripherin...
April 12, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28403666/enhanced-acyclovir-delivery-using-w-o-type-microemulsion-preclinical-assessment-of-antiviral-activity-using-murine-model-of-zosteriform-cutaneous-hsv-1-infection
#9
Amanpreet Kaur, Gajanand Sharma, Vishal Gupta, Radha Kanta Ratho, Om Prakash Katare
The present study was aimed to develop and evaluate a microemulsion-based dermal drug delivery of an antiviral agent, acyclovir. A water-in-oil microemulsion was prepared using isopropyl myristate, Tween 20, Span 20, water and dimethylsulphoxide. It was characterized for drug content, stability, globule size, pH, viscosity and ex vivo permeation through mice skin. In vivo antiviral efficacy of optimized formulation was assessed in female Balb/c mice against herpes simplex virus-I (HSV-I)-induced infection. It was observed that optimized formulation when applied 24-h post-infection could completely inhibit the development of cutaneous herpetic lesions vis-à-vis marketed cream...
April 12, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28400993/criteria-to-screen-molecular-tests-for-the-diagnosis-of-herpes-simplex-virus-in-the-central-nervous-system-have-no-propensity-to-harm
#10
Ronald George Hauser, Cynthia A Brandt, Richard A Martinello
OBJECTIVES: Investigators have ruled out herpes simplex virus (HSV) infection without the detection of herpes simplex deoxyribonucleic acid in cerebrospinal fluid (CSF) (i.e., HSV polymerase chain reaction [PCR]) by laboratory (normal CSF white blood cell count and protein) and clinical criteria (age ≥2 years, no history of human immunodeficiency virus or solid-organ transplant). Compared to HSV PCR of all samples, the algorithm saves money in test costs and may decrease exposure to acyclovir by illustrating the low probability that the patient has HSV...
2017: Journal of Pathology Informatics
https://www.readbyqxmd.com/read/28399708/tuberculosis-of-the-glans-penis-an-important-differential-diagnosis-of-genital-ulcer-disease
#11
Archana Singal, Deepika Pandhi, Vandana Kataria, Vinod K Arora
We report a 45-year-old, apparently healthy sero-negative man, presenting with multiple ulcers on the glans penis for a duration of three months. There was no significant inguinal lymphadenopathy. He showed no improvement on systemic antibiotics and acyclovir. Histopathology revealed the diagnosis of genital tuberculosis (TB), and polymerase chain reaction for Mycobacterium tuberculosis tested positive. The patient responded well to category I anti-tubercular treatment with complete resolution of lesions in six months...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28398421/herpes-zoster-following-varicella-vaccination-in-children
#12
Darren J Guffey, Sarah B Koch, Leonora Bomar, William W Huang
Herpes zoster (HZ), or shingles, is commonly seen in older adults but does occur in children. Routine administration of the varicella vaccine started in 1995 in the United States; since then, the incidence of varicella and HZ has declined. We report a case of HZ in an otherwise healthy 19-month-old boy who had been vaccinated at 13 months of age and recovered fully after acyclovir treatment. We review previously reported cases of HZ in healthy vaccinated children.
March 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28397560/herpes-simplex-virus-laryngitis-presenting-as-airway-obstruction-a-case-report-and-literature-review
#13
Lucas Harless, Nancy Jiang, Frank Schneider, Megan Durr
OBJECTIVES: Herpes simplex virus (HSV) laryngitis is rare in adults. We add a case report to the literature and perform a literature review to further delineate the clinical presentation, course, and treatment of HSV laryngitis in adults. METHODS: Case report and literature review using PubMed and Ovid databases. RESULTS: Ten cases of diagnosed HSV laryngitis in adults were reported in the literature. It is more common in immunocompromised patients...
May 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28396205/entry-inhibition-of-hsv-1-and-2-protects-mice-from-viral-lethal-challenge
#14
Nicola Clementi, Elena Criscuolo, Francesca Cappelletti, Paola Quaranta, Mauro Pistello, Roberta A Diotti, Giuseppe A Sautto, Alexander W Tarr, Federico Mailland, Daniela Concas, Roberto Burioni, Massimo Clementi, Nicasio Mancini
The present study focused on inhibition of HSV-1 and -2 replication and pathogenesis in vitro and in vivo, through the selective targeting of the envelope glycoprotein D. Firstly, a human monoclonal antibody (Hu-mAb#33) was identified that could neutralise both HSV-1 and -2 at nM concentrations, including clinical isolates from patients affected by different clinical manifestations and featuring different susceptibility to acyclovir in vitro. Secondly, the potency of inhibition of both infection by cell-free viruses and cell-to-cell virus transmission was also assessed...
April 8, 2017: Antiviral Research
https://www.readbyqxmd.com/read/28386807/acute-human-herpes-virus-7-hhv-7-encephalitis-in-an-immunocompetent-adult-patient-a-case-report-and-review-of-literature
#15
Nicoletta Riva, Iacopo Franconi, Marianna Meschiari, Erica Franceschini, Cinzia Puzzolante, Gianluca Cuomo, Alessandro Bianchi, Francesca Cavalleri, Maurilio Genovese, Cristina Mussini
We report a case of an acute HHV-7 encephalitis involving the nucleus of the VI cranial nerve in an immunocompetent host. The patient was an adult male admitted to our Clinic with headache, diplopia, fever, nausea, vertigo, asthenia and general malaise. PCR for viral and bacterial genomes was run on both serum and cerebral spinal fluid (CSF) after performing lumbar puncture, resulting positive only for HHV-7 DNA on CSF. MRI showed hyperintensity in FLAIR signal in the dorsal pons, in the area of the VI cranial nerve nucleus...
April 6, 2017: Infection
https://www.readbyqxmd.com/read/28383421/varicella-zoster-virus-infection-after-allogeneic-hematopoietic-cell-transplantation-in-children-using-a-relatively-short-duration-of-acyclovir-prophylaxis-a-retrospective-study
#16
Seung Beom Han, Seong Koo Kim, Jae Wook Lee, Dong-Gun Lee, Nack-Gyun Chung, Dae Chul Jeong, Bin Cho, Jin-Han Kang
Although acyclovir prophylaxis against varicella zoster virus (VZV) infection for ≥1 year is recommended after allogeneic hematopoietic cell transplantation (HCT), the emergence of acyclovir-resistant viruses and adverse drug effects cannot be ignored. We investigated the cumulative incidence of VZV infection after allogeneic HCT in children receiving a shorter duration of acyclovir prophylaxis than recommended and evaluated the appropriateness of the short duration of acyclovir prophylaxis.Medical records of 217 children who received allogeneic HCT were retrospectively reviewed until a median of 25 months (range = 1-59 months) after HCT...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28379476/delayed-recurrence-of-herpes-simplex-virus-infection-in-the-central-nervous-system-after-neonatal-infection-and-completion-of-six-months-of-suppressive-therapy
#17
Baylee Henderson, David W Kimberlin, Sarah E Fjie
A 10-day-old child was treated for neonatal herpes simplex virus (HSV) central nervous system (CNS) disease with 21 days of intravenous acyclovir and 6 months of oral acyclovir. She presented 7 years later with HSV CNS disease and new lesions in her brain, illustrating the non-benign nature of delayed recurrent HSV CNS disease.
April 4, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28375913/bell-s-palsy
#18
Stephen G Reich
PURPOSE OF REVIEW: Bell's palsy is a common outpatient problem, and while the diagnosis is usually straightforward, a number of diagnostic pitfalls can occur, and a lengthy differential diagnosis exists. Recognition and management of Bell's palsy relies on knowledge of the anatomy and function of the various motor and nonmotor components of the facial nerve. Avoiding diagnostic pitfalls relies on recognizing red flags or features atypical for Bell's palsy, suggesting an alternative cause of peripheral facial palsy...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28370067/resolution-of-acyclovir-associated-neurotoxicity-with-the-aid-of-improved-clearance-estimates-using-a-bayesian-approach-a-case-report-and-review-of-the-literature
#19
W A Watson, N J Rhodes, I A Echenique, M P Angarone, M H Scheetz
WHAT IS KNOWN AND OBJECTIVE: Neurotoxicity is a side effect of acyclovir. We report the first case, to our knowledge, whereby Bayesian-informed clearance estimates supported a therapeutic intervention for acyclovir-associated neurotoxicity. CASE SUMMARY: A 62-year-old male with the diagnosis of disseminated zoster was being treated with intravenous (IV) acyclovir when he developed symptoms of acute neurotoxicity. Acyclovir had been dose-adjusted for renal dysfunction according to traditional creatinine clearance estimates; however, as the patient was also on vancomycin, Bayesian estimates of vancomycin clearances were performed, which revealed a 2-fold lower creatinine clearance...
June 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28369502/severe-parechovirus-3-infections-in-young-infants-kansas-and-missouri-2014
#20
Claire M Midgley, Mary Anne Jackson, Rangaraj Selvarangan, Patrick Franklin, Elizabeth L Holzschuh, Jennifer Lloyd, Joseph Scaletta, Anne Straily, Sheri Tubach, Ashley Willingham, W Allan Nix, M Steven Oberste, Christopher J Harrison, Charles Hunt, George Turabelidze, Susan I Gerber, John T Watson
Background.: Infection with parechovirus type 3 (PeV3) can cause severe neurologic and sepsis-like illness in young infants; clinical and epidemiologic descriptions have been limited. We aimed to characterize PeV3 illness and explore risk factors for acquisition in a cluster of neonatal cases at Children's Mercy Hospital in Kansas City, Missouri. Methods.: Cerebrospinal fluid specimens were obtained from infants aged <180 days who were hospitalized with sepsis-like illness or meningitis between June 1 and November 1, 2014...
March 29, 2017: Journal of the Pediatric Infectious Diseases Society
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