Abstract
A 36-year-old Japanese man who received an unrelated bone marrow transplant (BMT) developed severe mucocutaneous infection with herpes simplex virus (HSV) type 1 during oral acyclovir prophylaxis. The lesions progressed despite treatment with intravenous acyclovir and vidarabine. The HSV isolates were sensitive acyclovir, vidarabine and foscarnet in vitro, but peripheral CD3- or CD19-positive cells were barely detectable even 4 months after transplant. A 12-day course of treatment with foscarnet led to a rapid improvement. Foscarnet therapy should be considered for all severe HSV infections following BMT, regardless of whether or not the HSV isolates are sensitive to acyclovir.
Publication types
-
Case Reports
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Acyclovir / pharmacology
-
Acyclovir / therapeutic use
-
Adult
-
Antiviral Agents / pharmacology
-
Antiviral Agents / therapeutic use*
-
Bone Marrow Transplantation*
-
Drug Resistance, Microbial
-
Foscarnet / pharmacology
-
Foscarnet / therapeutic use*
-
Herpes Labialis / chemically induced
-
Herpes Labialis / drug therapy
-
Herpes Labialis / etiology*
-
Humans
-
Leukemia, Myeloid, Accelerated Phase / therapy
-
Male
-
Neutropenia / chemically induced
-
Neutropenia / complications
-
Simplexvirus / drug effects
-
Simplexvirus / isolation & purification
-
Stomatitis, Herpetic / drug therapy
-
Stomatitis, Herpetic / etiology*
-
Stomatitis, Herpetic / virology
-
Transplantation Conditioning / adverse effects
-
Transplantation, Homologous
-
Vidarabine / pharmacology
-
Vidarabine / therapeutic use
-
Whole-Body Irradiation / adverse effects
Substances
-
Antiviral Agents
-
Foscarnet
-
Vidarabine
-
Acyclovir