RESUMO
The appearance on the skin of herpes virus lesions, concomitantly with the coronavirus disease 2019 (COVID-19) pandemic, leads us to suspect an underlying infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Diagnostic reverse transcriptase polymerase chain reaction tests and immunoglobulin M (IgM) and IgG seroconversion studies have therefore been carried out. We present three cases of herpes virus infections in immunocompetent patients: one of the infections was herpes simplex 1 in a 40-year-old woman, and the other two were herpes varicella-zoster infections in a 62-year-old man and a 25-year-old woman. The patients were in the care of the southern health district of Seville of the SAS (Andalusian Health Service) during the Spanish state of alarm over the COVID-19 pandemic. The SARS-CoV-2 infection was confirmed in only one of the three cases. In this study, we briefly review the etiopathogenic role of the COVID-19 pandemic situation, whereby immunodeficiencies are generated that favour the appearance of other viral infections, such as herpes virus infections.
Assuntos
COVID-19/complicações , Herpes Simples/etiologia , Herpes Zoster/etiologia , Herpesvirus Humano 3/fisiologia , Simplexvirus/fisiologia , Ativação Viral , Adulto , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Herpes Simples/diagnóstico , Herpes Simples/virologia , Herpes Zoster/diagnóstico , Herpes Zoster/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espanha/epidemiologiaRESUMO
BACKGROUND: Dupilumab, the first biological drug to be approved for the treatment of moderate to severe atopic dermatitis in adolescents and adults, has shown good efficacy and safety in clinical trials. OBJECTIVE: To evaluate real-world data on the efficacy and safety of dupilumab in atopic dermatitis. METHODS: PubMed and EMBASE were searched for observational studies with data on efficacy, drug survival, and safety of dupilumab for the treatment of atopic dermatitis. Primary outcomes were mean percentage change in Eczema Area and Severity Index (EASI) score and proportion of atopic dermatitis patients achieving 50%, 75%, and 90% improvement in EASI score after dupilumab therapy. RESULTS: Twenty-two unique studies encompassing 3303 atopic dermatitis patients were included. After 16 weeks of dupilumab therapy, the pooled proportion of patients achieving 50%, 75%, and 90% EASI score improvement was 85.1%, 59.8%, and 26.8%, respectively, and the weighted mean reduction in EASI score was 69.6%. Conjunctivitis was the most common adverse event, reported in a pooled proportion of 26.1%. LIMITATIONS: Limited data in terms of size and follow-up time were available. CONCLUSION: Real-world data show that dupilumab is a successful and well-tolerated therapy for atopic dermatitis, but ocular adverse events commonly occur. Registries are needed to monitor for adverse events.
Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/efeitos adversos , Fármacos Dermatológicos/uso terapêutico , Subunidade alfa de Receptor de Interleucina-4/antagonistas & inibidores , Blefarite/induzido quimicamente , Conjuntivite/induzido quimicamente , Herpes Simples/etiologia , Humanos , Ceratite/induzido quimicamente , Resultado do TratamentoRESUMO
INTRODUCTION: We report on patients who developed severe acyclovir-resistant (ACVr) herpes simplex virus 1 (HSV-1) stomatitis after allogeneic hematopoietic cell transplantation (HCT). PATIENTS: HCT patients suffering from HSV-1 stomatitis without response after 1 week of high-dose acyclovir (ACV) were tested for ACV resistance. Patients with proven ACV resistance were treated either topically with cidofovir solution and gel or with topical foscavir cream or with intravenous foscavir. RESULTS: Among 214 consecutive HCT patients, 6 developed severe ACVr HSV-1 stomatitis (WHO grade III n = 1, WHO grade IV n = 5). All 6 patients suffered from relapse of acute myeloid leukemia (AML) after HCT. ACVr stomatitis was treated topically with first-line (n = 4) or second-line (n = 2) cidofovir. Topical foscavir cream was applied as first-line (n = 1) or second-line (n = 1) therapy. Intravenous foscavir was used in 3 patients (first-line therapy, n = 1; second-line therapy, n = 2). Complete remission was reached by topical cidofovir (n = 3), topical foscavir (n = 1), and intravenous foscavir (n = 1), respectively. Five of the 6 patients died due to progression of leukemia. Only 1 patient survived. CONCLUSIONS: ACVr HSV-1 stomatitis is a severe complication in AML patients relapsing after HCT. It reflects the seriously impaired general condition of these patients. This analysis shows that topical treatment with cidofovir or foscavir might be a sufficient first-line therapy approach in ACVr HSV-1 stomatitis. It might serve as a less toxic alternative to intravenous foscavir.
Assuntos
Antivirais/administração & dosagem , Cidofovir/administração & dosagem , Foscarnet/administração & dosagem , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Herpes Simples/tratamento farmacológico , Estomatite/tratamento farmacológico , Aciclovir/administração & dosagem , Aciclovir/farmacologia , Administração Tópica , Adulto , Idoso , Farmacorresistência Viral/efeitos dos fármacos , Feminino , Transplante de Células-Tronco Hematopoéticas/métodos , Herpes Simples/etiologia , Herpesvirus Humano 1/efeitos dos fármacos , Humanos , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Masculino , Pessoa de Meia-Idade , Estomatite/virologia , Resultado do TratamentoAssuntos
Agulhamento Seco , Melanose/terapia , Ácido Tranexâmico/uso terapêutico , Adulto , Idoso , Alopecia/etiologia , Terapia Combinada , Agulhamento Seco/efeitos adversos , Feminino , Herpes Simples/etiologia , Humanos , Melanose/tratamento farmacológico , Melanose/psicologia , Pessoa de Meia-Idade , Dor/etiologia , Qualidade de Vida , Índice de Gravidade de Doença , Protetores Solares , Ácido Tranexâmico/efeitos adversos , Ativação Viral , Transtornos da Visão/etiologia , Adulto JovemRESUMO
Fractional photothermolysis was initially introduced by Manstein in 2004 .Fractional CO2 laser technology introduced has allowed physicians to obtain good cosmetic results with a lower rate of complications than non-fractionated ablative laser treatment. However, adverse effects may still occur.Reported cases of HSV infection after fractional photothermolysis are rare. A 48-year-old woman with Fitzpatrick skin type III presented with a scar in her perioral area desiring esthetic improvement of her burn scar. She didn't have a history of recurrent herpes simplex virus (HSV) infection periorally. A fractionated resurfacing laser Quadralase (Candela) was used to treat her perioral burn scar. Two sessions were performed with a month interval. Five days after the second session of laser therapy even after she took antiviral prophylaxis based on valacyclovir 500mg twice daily 24 hours before the laser session and 3 days after, she presented with a rash on the perioral area preceded by pain. Correlation of the history and the clinical presentation was consistent with HSV reactivation. Treatment was initiated with acyclovir 10mg/kg/8h administered intravenously for 10 days with a clearing of her vesicular eruption. Fractional CO2 laser is a very safe procedure when used with accepted parameters. Early recognition, close monitoring and careful wound care will prevent long term sequelae when complications occur.
Assuntos
Queimaduras/complicações , Cicatriz/radioterapia , Herpes Simples/etiologia , Lasers de Gás/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Simplexvirus/efeitos da radiação , Ativação Viral/efeitos da radiação , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Administração Intravenosa , Antibioticoprofilaxia , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Cicatriz/etiologia , Fracionamento da Dose de Radiação , Feminino , Seguimentos , Herpes Simples/tratamento farmacológico , Humanos , Lasers de Gás/uso terapêutico , Pessoa de Meia-Idade , Boca/patologia , Simplexvirus/fisiologia , Resultado do TratamentoRESUMO
We report a case of herpes gladiatorum (HG) in a professional mixed martial arts (MMA) fighter. The eruption appeared following a sparring session with a new partner and progressed to involve the left eye. Fever and facial rash prompted the patient to go to the hospital where he was treated with antiviral therapy. The considerable increase in popularity of MMA may lead to a greater prevalence of HG as well as other cutaneous infections contracted through skin-to-skin contact.
Assuntos
Conjuntivite Viral/transmissão , Herpes Simples/transmissão , Artes Marciais , Adulto , Antivirais/uso terapêutico , Conjuntivite Viral/tratamento farmacológico , Conjuntivite Viral/etiologia , Febre/virologia , Herpes Simples/tratamento farmacológico , Herpes Simples/etiologia , Herpesvirus Humano 1/isolamento & purificação , Humanos , MasculinoRESUMO
Herpes simplex virus bronchopneumonitis is a clinical entity described in critically ill patients and classically associated to immunosuppression. Recent reports have shown a higher frequency of virus detection from samples obtained by bronchoalveolar lavage of immunocompetent critically ill patients undergoing mechanical ventilation. This fact suggests its role as an independent pathogenic substrate. We report the case of a female patient who was admitted after an elective surgery of rectal tumor with suspected bronchoaspiration during anesthetic induction. The patient presented persistent fever despite broad spectrum antibiotic treatment. All cultures were negative for bacterial growth. The chest X-ray did not show opacifities. Prolonged mechanical ventilation with repeated failures to wean made it mandatory to perform percutaneous tracheostomy. A fibrobronchoscopy with bronchoalveolar lavage, performed previously, showed positive result for herpes simplex virus (PCR and specific nuclear inclusions in cells). Thus, treatment was initiated with acyclovir, with clinical improvement and weaning from mechanical ventilation.
Assuntos
Broncopneumonia/etiologia , Herpes Simples/etiologia , Pneumonia Viral/etiologia , Complicações Pós-Operatórias/etiologia , Insuficiência Respiratória/etiologia , Doença Aguda , Aciclovir/uso terapêutico , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/radioterapia , Adenocarcinoma/cirurgia , Idoso , Antimetabólitos Antineoplásicos/efeitos adversos , Antimetabólitos Antineoplásicos/uso terapêutico , Antivirais/uso terapêutico , Líquido da Lavagem Broncoalveolar/virologia , Broncopneumonia/diagnóstico , Broncopneumonia/tratamento farmacológico , Terapia Combinada , Diagnóstico Diferencial , Feminino , Fluoruracila/efeitos adversos , Fluoruracila/uso terapêutico , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Pneumonia Aspirativa/diagnóstico , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/terapia , Complicações Pós-Operatórias/virologia , Radioterapia Adjuvante , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Respiração Artificial , Insuficiência Respiratória/terapiaRESUMO
OBJECTIVE: To determine the incidence of possible neonatal herpes simplex virus (HSV) infections, HSV infection status of women with infected infants, and use of measures to reduce risk of HSV transmission to the neonate in a large US managed-care population. STUDY DESIGN: Retrospective analysis of administrative claims from the Integrated Health Care Information Services National Managed Care Benchmark database. RESULTS: Of 233,487 infants born to 252,474 mothers from January 1997 to June 2002, the numbers assigned an ICD-9 code reflecting possible neonatal HSV infection =30 and =90 days of birth were 178 (0.08%) and 338 (0.15%), respectively. Of the 338 mothers delivering infants with possible neonatal HSV =90 days postnatally, 12% had a prior HSV diagnosis, 5% were prescribed an antiviral medication during the study period, and 3% used antiviral medication and had a cesarean delivery. CONCLUSION: These results support national surveillance of neonatal HSV to better define its incidence, strengthen health policies, and improve prevention and treatment.
Assuntos
Herpes Simples/epidemiologia , Herpes Simples/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Grupos Diagnósticos Relacionados/estatística & dados numéricos , Feminino , Herpes Simples/etiologia , Herpes Simples/transmissão , Humanos , Incidência , Recém-Nascido , Masculino , Programas de Assistência Gerenciada , Prontuários Médicos , Gravidez , Complicações Infecciosas na Gravidez/etiologia , Cuidado Pré-Natal , Estudos Retrospectivos , Estados Unidos/epidemiologiaAssuntos
Herpes Simples/diagnóstico , Terapia com Luz de Baixa Intensidade/efeitos adversos , Mancha Vinho do Porto/radioterapia , Infecções por Pseudomonas/diagnóstico , Síndrome de Sturge-Weber , Pré-Escolar , Diagnóstico Diferencial , Face , Feminino , Herpes Simples/etiologia , Humanos , Mancha Vinho do Porto/patologia , Infecções por Pseudomonas/etiologia , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/etiologiaRESUMO
BACKGROUND: Growth hormone (GH) has been shown to promote wound healing and to improve protein metabolism in burned patients. Through immunomodulation, GH has also protected rats infected with Salmonella typhimurium and mice infected with Escherichia coli. In spite of advances in the management of patient care for those with thermal injuries, high mortality rates of burned patients as a result of infections are of special concern. An improvement in the resistance of burned patients to certain infections will make the beneficial role of GH very clear. In this study, therefore, the immunomodulating effects of recombinant human GH (rhGH) in thermally injured mice exposed to opportunistic herpesvirus infections were investigated. METHODS: (1) Burned mice, exposed to herpes simplex virus type 1 (HSV-1), were treated subcutaneously with rhGH (4 mg/kg) and observed for 21 days to determine the protective antiviral effect of rhGH. (2) Because of reports describing a lack of interferon-gamma (IFN-gamma) responsiveness in burned mice, the IFN-gamma-producing ability of the splenic mononuclear cells (SMNC) from burned mice treated with rhGH was examined. (3) Because the generation of burn-associated suppressor macrophages that can inhibit the IFN-gamma production by SMNC has been previously described, the suppressor cell activities of macrophages from burned mice treated with rhGH were examined. RESULTS: After exposure to lethal amounts of HSV-1, mice treated with rhGH displayed a reduced mortality rate compared with control mice treated with saline. SMNC from burned mice treated with rhGH produced IFN-gamma, whereas this cytokine was not produced by SMNC from burned mice treated with saline. Also, an inhibition of the generation of burn-associated suppressor macrophages was displayed in burned mice treated with rhGH. CONCLUSION: Exogenous administration of rhGH caused an improvement in the resistance of burned mice to HSV-1 infection. In burned mice treated with rhGH, the impaired IFN-gamma responsiveness was restored and the generation of burn-associated suppressor macrophages was inhibited. IFN-gamma, a typical antiviral cytokine induced by rhGH through the regulation of the suppressor macrophage generation, may therefore play a role in the protection of burned mice infected with a lethal amount of HSV-1.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Queimaduras/complicações , Hormônio do Crescimento/uso terapêutico , Herpes Simples/terapia , Infecção dos Ferimentos/terapia , Animais , Queimaduras/metabolismo , Avaliação Pré-Clínica de Medicamentos , Hormônio do Crescimento/imunologia , Herpes Simples/etiologia , Herpes Simples/imunologia , Humanos , Imunidade Inata/efeitos dos fármacos , Interferon gama/metabolismo , Leucócitos Mononucleares/metabolismo , Macrófagos/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Ratos , Baço/imunologia , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/etiologia , Infecção dos Ferimentos/imunologiaRESUMO
É apresentada uma revisäo das publicaçöes mais recentes sobre o herpes simplex vírus, com ênfase às relaçöes com transmissäo, tratamento e controle
Assuntos
Humanos , Aciclovir/uso terapêutico , Corticosteroides/uso terapêutico , Antivirais , Vacina BCG/uso terapêutico , Cloranfenicol/uso terapêutico , Éter/uso terapêutico , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Herpes Simples/etiologia , Herpes Simples/terapia , Idoxuridina/uso terapêutico , Imunoglobulina G/uso terapêutico , Inosina Pranobex/uso terapêutico , Interferon-alfa/uso terapêutico , Levamisol/uso terapêutico , Neomicina/uso terapêutico , Nucleosídeos/uso terapêutico , Fototerapia , Timol/uso terapêutico , Vacinas Virais/uso terapêuticoRESUMO
STUDY OBJECTIVE: To determine whether trisodium phosphonoformate (foscarnet) is efficacious in treating severe mucocutaneous disease due to acyclovir-resistant herpes simplex virus type-2 (HSV-2) infection in patients with the acquired immunodeficiency syndrome (AIDS). DESIGN: Open-labeled drug administration to patients with AIDS and severe ulcerative disease due to acyclovir-resistant HSV-2 infection. SETTING: Medical floors of acute care hospital. PATIENTS: Four patients with AIDS who developed progressive ulcerative mucocutaneous lesions of the genitals, perineum, perianal region, or finger due to acyclovir-resistant, thymidine-kinase (TK)-negative strains of HSV-2. INTERVENTION: Foscarnet, 60 mg/kg body weight intravenously every 8 hours (with reduced dosage for renal impairment), for 12 to 50 days. MEASUREMENT AND MAIN RESULTS: All patients receiving foscarnet had dramatic improvement in their clinical findings with marked clearing of mucocutaneous lesions and eradication of HSV from mucosal surfaces. CONCLUSION: Foscarnet may be an effective treatment for severe mucocutaneous disease due to acyclovir-resistant, TK-negative strains of HSV-2.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Antivirais/uso terapêutico , Herpes Simples/tratamento farmacológico , Compostos Organofosforados/uso terapêutico , Ácido Fosfonoacéticos/uso terapêutico , Aciclovir/uso terapêutico , Adulto , Antivirais/administração & dosagem , Resistência Microbiana a Medicamentos , Foscarnet , Herpes Simples/etiologia , Humanos , Infusões Intravenosas , Masculino , Testes de Sensibilidade Microbiana , Ácido Fosfonoacéticos/administração & dosagem , Ácido Fosfonoacéticos/análogos & derivadosRESUMO
New experimental models of neurological herpes in cotton rats and genital herpes in male guinea pigs have been developed which are more adequate to the corresponding human diseases, and models of ophthalmic herpes in rabbits and guinea pigs have been improved. These models may be used for screening and evaluation of the effectiveness of drugs for herpes. A high activity against herpes of bromovinyldeoxyuridine and acyclovir has been verified, a marked therapeutic effect of Soviet monophosphates ara-A, ara-C, and original silur preparation in some forms of herpes infection has been demonstrated.
Assuntos
Modelos Animais de Doenças , Herpes Simples/etiologia , Animais , Antivirais/uso terapêutico , Arvicolinae , Células Cultivadas , Avaliação Pré-Clínica de Medicamentos , Cobaias , Herpes Genital/tratamento farmacológico , Herpes Genital/etiologia , Herpes Genital/patologia , Herpes Simples/tratamento farmacológico , Herpes Simples/patologia , Humanos , Ceratite Dendrítica/tratamento farmacológico , Ceratite Dendrítica/etiologia , Ceratite Dendrítica/patologia , Masculino , Meningoencefalite/tratamento farmacológico , Meningoencefalite/etiologia , Meningoencefalite/patologia , Camundongos , Coelhos , Cultura de VírusAssuntos
Hormônio Adrenocorticotrópico/efeitos adversos , Herpes Simples/etiologia , Vidarabina/uso terapêutico , Hormônio Adrenocorticotrópico/uso terapêutico , Ataxia Cerebelar/tratamento farmacológico , Herpes Simples/tratamento farmacológico , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Simplexvirus/efeitos dos fármacos , Vidarabina/farmacologiaRESUMO
Over 25 episodes of severe chronic and recurrent mucocutaneous herpes simplex virus infections in five immunodeficient patients were successfully treated with intravenous or oral acyclovir treatment. Acyclovir was shown to inhibit viral shedding rapidly, to be well tolerated, and to permit the complete healing of lesions. As expected, a course of acyclovir did not prevent later recurrences of the herpes virus infections. However, symptomatic recurrences were successfully suppressed during long (up to 65-day) courses of oral acyclovir.
Assuntos
Antivirais/uso terapêutico , Guanina/análogos & derivados , Herpes Simples/tratamento farmacológico , Síndromes de Imunodeficiência/complicações , Aciclovir , Adulto , Idoso , Antivirais/efeitos adversos , Antivirais/metabolismo , Pré-Escolar , Feminino , Guanina/efeitos adversos , Guanina/metabolismo , Guanina/uso terapêutico , Herpes Simples/etiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Mucosa , RecidivaRESUMO
Photodynamic inactivation with neutral red (a heterotricyclic dye) and light was evaluated in a placebo-controlled study of 170 episodes of recurrent infection with herpes simplex virus in 96 patients. The technique inactivated herpes simplex virus in vitro. However, no beneficial effect, either on the rate of resolution of herpetic lesions or on the interval to subsequent recurrences, was observed in treated patients. These negative results should not deter further investigation of photodynamic inactivation as a potential treatment for herpes simplex virus infections, but the clinical application of this form of therapy should be limited to properly controlled studies until its efficacy is proven.