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1.
Medicine (Baltimore) ; 99(24): e20394, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541459

RESUMO

INTRODUCTION: Hyaluronic acid injections is relatively safe with little risk of complications. Although herpes reactivation after the injection of hyaluronic acid is rare, it produces quite a huge pressure and panic on patients. Quite a lot cosmetic practitioners have no awareness of preventing, diagnosing, and giving correct treatment in time due to lack of experience. PATIENT CONCERNS: A 24-year-old woman presented with erythema, crusted papules, pain and swelling on the nose after receiving the injection of hyaluronic acid. A swab of the discharge fluid was obtained for bacterial and viral culture, showing positive for herpes simplex virus. DIAGNOSIS: The patient was diagnosed as herpes reactivation after the injection of hyaluronic acid. INTERVENTIONS: The patient underwent antiviral therapy with acyclovir 400 mg, 3 times daily for seven days. OUTCOMES: After a week of antiviral treatment, the clinical signs improved. CONCLUSION: Herpes reactivation after the injection of hyaluronic acid is quite rare but needed sufficient attention of cosmetic practitioners to make the proper diagnosis, prevention and treatment.


Assuntos
Preenchedores Dérmicos/efeitos adversos , Herpes Simples/induzido quimicamente , Ácido Hialurônico/efeitos adversos , Nariz/virologia , Simplexvirus/isolamento & purificação , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Administração Oral , Adulto , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Preenchedores Dérmicos/administração & dosagem , Feminino , Herpes Simples/patologia , Herpes Simples/prevenção & controle , Humanos , Ácido Hialurônico/administração & dosagem , Nariz/patologia , Resultado do Tratamento , Adulto Jovem
2.
Rinsho Shinkeigaku ; 60(7): 485-488, 2020 Jul 31.
Artigo em Japonês | MEDLINE | ID: mdl-32536667

RESUMO

A 79-year-old man presented with chest and back pain on the right side but with no cutaneous lesions. He had received oral corticosteroids and immunosuppressants for systemic lupus erythematosus. He had spastic paraplegia, sensory disturbance in the lower limbs, and dysfunction of the bladder and bowel. He showed mononuclear-dominant pleocytosis and elevated proteins in the cerebrospinal fluid (CSF), and a decreased CSF/blood glucose ratio. Although polymerase chain reaction techniques found no varicella-zoster virus (VZV) DNA, VZV IgG antibodies were elevated in both the serum and CSF, and the VZV IgG index was dramatically elevated. MRI revealed no lesions in the brain or spine. However, somatosensory evoked potentials in the tibial nerve showed abnormal prolongation of the central sensory conduction time. We diagnosed the patient with acute myelitis associated with zoster sine herpete (ZSH). He received acyclovir and intravenous methylprednisolone pulse therapy in the early stage, and his symptoms and CSF findings completely recovered. We conclude that acute myelitis associated with ZSH should be treated as soon as possible because VZV infection may induce necrotizing myelitis if the treatment is delayed.


Assuntos
Aciclovir/administração & dosagem , Antivirais/administração & dosagem , Metilprednisolona/administração & dosagem , Mielite/tratamento farmacológico , Mielite/virologia , Zoster Sine Herpete , Doença Aguda , Idoso , Biomarcadores/sangue , Imagem de Difusão por Ressonância Magnética , Diagnóstico Precoce , Herpesvirus Humano 3/imunologia , Humanos , Hospedeiro Imunocomprometido , Imunoglobulina G/sangue , Lúpus Eritematoso Sistêmico , Masculino , Mielite/diagnóstico , Pulsoterapia , Fatores de Tempo , Resultado do Tratamento
4.
Psychopharmacology (Berl) ; 237(6): 1851-1860, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32221697

RESUMO

Alzheimer's disease (AD) is the most common neurodegenerative disease. However, effective drugs for this disease have not yet been developed. The analysis of big data indicated that childhood herpes virus infection may be associated with the incidence of AD, suggesting that anti-herpetic drugs, such as acyclovir, may have preventive and suppressive effects in AD therapy. Moreover, short-term use of dexamethasone (DXMT), a clinical used synthetic corticosteroid, could effectively inhibit AD-related neuroinflammation. In this study, we have found that the combination of acyclovir and DXMT, but not acyclovir or DXMT alone, could protect against AD causing ß-amyloid (Aß) oligomer-induced spatial cognitive impairments. Moreover, acyclovir and DXMT could prevent Aß oligomer-induced over-activation of microglia and astrocytes, and over-expression of pro-inflammatory cytokines, indicating that anti-AD effects of drug combination might be at least partially via neuroinflammation inhibition and immunomodulation. Furthermore, Aß oligomer-induced decrease of PSD-95 and increase of pTau expression was prevented by the combination of acyclovir and DXMT, suggesting the involvement of synaptic protective effects of the drug combination. Taken together, our studies indicated that the combination of acyclovir and DXMT might be an alternative therapy for the treatment of AD.


Assuntos
Aciclovir/administração & dosagem , Doença de Alzheimer/prevenção & controle , Peptídeos beta-Amiloides/toxicidade , Disfunção Cognitiva/prevenção & controle , Dexametasona/administração & dosagem , Fármacos Neuroprotetores/administração & dosagem , Fragmentos de Peptídeos/toxicidade , Doença de Alzheimer/induzido quimicamente , Doença de Alzheimer/metabolismo , Animais , Astrócitos/efeitos dos fármacos , Astrócitos/metabolismo , Disfunção Cognitiva/induzido quimicamente , Disfunção Cognitiva/metabolismo , Quimioterapia Combinada , Masculino , Camundongos , Microglia/efeitos dos fármacos , Microglia/metabolismo
5.
J Pediatr ; 219: 126-132.e2, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32037154

RESUMO

OBJECTIVE: To describe the epidemiology of and risk factors associated with acute kidney injury (AKI) during acyclovir treatment in neonates and infants. STUDY DESIGN: We conducted a multicenter (n = 4), retrospective cohort study of all hospitalized infants age <60 days treated with intravenous acyclovir (≥1 dose) for suspected or confirmed neonatal herpes simplex virus disease from January 2011 to December 2015. Infants with serum creatinine measured both before acyclovir (baseline) and during treatment were included. We classified AKI based on changes in creatinine according to published neonatal AKI criteria and performed Cox regression analysis to evaluate risk factors for AKI during acyclovir treatment. RESULTS: We included 1017 infants. The majority received short courses of acyclovir (median, 5 doses). Fifty-seven infants (5.6%) developed AKI during acyclovir treatment, with an incidence rate of AKI at 11.6 per 1000 acyclovir days. Cox regression analysis identified having confirmed herpes simplex virus disease (OR, 4.35; P = .002), receipt of ≥2 concomitant nephrotoxic medications (OR, 3.07; P = .004), receipt of mechanical ventilation (OR, 5.97; P = .001), and admission to an intensive care unit (OR, 6.02; P = .006) as risk factors for AKI during acyclovir treatment. CONCLUSIONS: Among our cohort of infants exposed to acyclovir, the rate of AKI was low. Sicker infants and those exposed to additional nephrotoxic medications seem to be at greater risk for acyclovir-induced toxicity and warrant closer monitoring.


Assuntos
Lesão Renal Aguda/induzido quimicamente , Lesão Renal Aguda/epidemiologia , Aciclovir/efeitos adversos , Herpes Simples/tratamento farmacológico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Administração Intravenosa , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores de Risco
9.
BMJ Case Rep ; 12(12)2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31796440

RESUMO

Herpes simplex virus (HSV) can affect the central nervous system causing meningitis, encephalitis and, rarely, acute retinal necrosis. We present a case of a 46-year-old man, previously healthy complaining of a 5-day persistent headache and sudden loss of vision of his left eye that progressed to the right. We started ceftriaxone, methylprednisolone and acyclovir for suspected encephalitis with vasculitis. HSV-1 was identified in vitreous and aqueous humour. Therapy with acyclovir was maintained and two intravitreous boluses of foscarnet were administered, without improvement. Usually being a benign infection, HSV can, in rare cases like this, have catastrophic effects in the optic tract.


Assuntos
Aciclovir/administração & dosagem , Antivirais/administração & dosagem , Infecções Oculares Virais/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/terapia , Administração Intravenosa , Infecções Oculares Virais/complicações , Infecções Oculares Virais/diagnóstico por imagem , Herpesvirus Humano 1/isolamento & purificação , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Síndrome de Necrose Retiniana Aguda/complicações , Síndrome de Necrose Retiniana Aguda/diagnóstico por imagem , Síndrome de Necrose Retiniana Aguda/virologia , Corpo Vítreo/virologia
11.
Cutis ; 104(5): 295-296, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31886781

RESUMO

Eczema herpeticum has been well described in the setting of atopic dermatitis (AD) and other dermatoses. We present the case of a 2-month-old infant boy with cutaneous herpes simplex virus (HSV) infection within existing diffuse infantile seborrheic dermatitis. Providers should be aware that cutaneous HSV can be confined to a seborrheic distribution and may represent underlying epidermal dysfunction secondary to seborrheic dermatitis.


Assuntos
Dermatite Atópica/diagnóstico , Dermatite Seborreica/diagnóstico , Erupção Variceliforme de Kaposi/diagnóstico , Dermatoses do Couro Cabeludo/diagnóstico , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Dermatite Atópica/complicações , Dermatite Atópica/tratamento farmacológico , Dermatite Seborreica/complicações , Dermatite Seborreica/tratamento farmacológico , Diagnóstico Diferencial , Humanos , Lactente , Infusões Intravenosas , Erupção Variceliforme de Kaposi/complicações , Erupção Variceliforme de Kaposi/tratamento farmacológico , Masculino , Dermatoses do Couro Cabeludo/complicações , Dermatoses do Couro Cabeludo/tratamento farmacológico , Simplexvirus/isolamento & purificação
12.
Pharm Res ; 36(12): 180, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31728737

RESUMO

PURPOSE: To examine the potential of stratum corneum (SC) sampling via tape-stripping in humans to assess bioequivalence of topical acyclovir drug products, and to explore the potential value of alternative metrics of local skin bioavailability calculable from SC sampling experiments. METHODS: Three acyclovir creams were considered in two separate studies in which drug amounts in the SC after uptake and clearance periods were measured and used to assess bioequivalence. In each study, a "reference" formulation (evaluated twice) was compared to the "test" in 10 subjects. Each application site was replicated to achieve greater statistical power with fewer volunteers. RESULTS: SC sampling revealed similarities and differences between products consistent with results from other surrogate bioequivalence measures, including dermal open-flow microperfusion experiments. Further analysis of the tape-stripping data permitted acyclovir flux into the viable skin to be deduced and drug concentration in that 'compartment' to be estimated. CONCLUSIONS: Acyclovir quantities determined in the SC, following a single-time point uptake and clearance protocol, can be judiciously used both to objectively compare product performance in vivo and to assess delivery of the active into skin tissue below the barrier, thereby permitting local concentrations at or near to the site of action to be determined.


Assuntos
Aciclovir/farmacocinética , Antivirais/farmacocinética , Creme para a Pele/farmacocinética , Aciclovir/administração & dosagem , Administração Tópica , Adulto , Antivirais/administração & dosagem , Disponibilidade Biológica , Transporte Biológico , Liberação Controlada de Fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Permeabilidade , Pele/metabolismo , Absorção Cutânea , Creme para a Pele/administração & dosagem , Equivalência Terapêutica
13.
Rinsho Shinkeigaku ; 59(12): 834-839, 2019 Dec 25.
Artigo em Japonês | MEDLINE | ID: mdl-31761838

RESUMO

We report a case of acyclovir encephalopathy in a 77-year-old man who was introduced to peritoneal dialysis three years earlier. He developed herpes zoster and was treated with acyclovir (ACV) at 800 mg daily per oral. Two days later, he developed consciousness disturbance, hallucinations and asterixis. Acyclovir was stopped and continuous ambulatory peritoneal dialysis (CAPD) was switched to hemodialysis, which resulted in the resolution of his symptoms. Because the optimal dose of ACV varies among individuals depending on the bioavailability of ACV and metabolic enzyme activity, ACV encephalopathy can occur even when the acyclovir dose is modified according to the renal function of the affected patient. Because CAPD provides a poorer ACV clearance than hemodialysis, CAPD patients tend to have a higher risk of developing ACV encephalopathy and to recover more slowly. If CAPD patients develop ACV encephalopathy, a temporary change in the type of dialysis to hemodialysis should be considered.


Assuntos
Aciclovir/administração & dosagem , Aciclovir/efeitos adversos , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Encefalopatias/etiologia , Herpes Zoster/tratamento farmacológico , Diálise Peritoneal/efeitos adversos , Administração Oral , Idoso , Humanos , Masculino , Diálise Renal
15.
Rinsho Shinkeigaku ; 59(10): 641-645, 2019 Oct 26.
Artigo em Japonês | MEDLINE | ID: mdl-31564701

RESUMO

A 76-year-old Japanese female who was treated with long-term use of prednisolone at 10 mg/day for interstitial pneumonia developed acute right-dominant lower limb paralysis and then upper limb paralysis with herpes zoster eruptions on the right C7-Th1 dermatomes. On admission, right predominant quadriplegia was observed with sensory symptoms; Hughes functional grade was level 4; the hand grip power was right, 0, and left, 7 kg, the deep tendon reflexes were abolished throughout without pathologic reflexes. Twenty days after the onset of the symptoms, the cerebrospinal fluid (CSF) revealed mild increases of lymphocytes (13 cells/µl) and protein content (73 mg/dl). Varicella-zoster virus (VZV) PCR was negative in the CSF, but an enzyme immunoassay for VZV was positive in her serum and CSF, and the high titers were prolonged. Peripheral nerve conduction and F wave studies suggested right-dominant demyelinating polyradiculoneuropathy. A T1-weighted MR contrast image exhibited right-dominant high-intensity lesions on the C7-Th1 spinal roots and similar lesions on the L4-5 spinal roots. We compared with several similar cases from the literature and proposed that VZV itself involves the pathogenesis of the polyradiculoneuritis in immunocompromised hosts.


Assuntos
Herpes Zoster/complicações , Polirradiculoneuropatia/complicações , Polirradiculoneuropatia/virologia , Infecção pelo Vírus da Varicela-Zoster , Aciclovir/administração & dosagem , Aciclovir/efeitos adversos , Idoso , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Imagem de Difusão por Ressonância Magnética , Feminino , Síndrome de Guillain-Barré , Herpes Zoster/tratamento farmacológico , Herpesvirus Humano 3/imunologia , Humanos , Hospedeiro Imunocomprometido , Imunoglobulinas Intravenosas/administração & dosagem , Oxidiazóis/administração & dosagem , Polirradiculoneuropatia/diagnóstico , Polirradiculoneuropatia/tratamento farmacológico , Quadriplegia/etiologia
18.
Dermatol Ther ; 32(6): e13087, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31515892

RESUMO

Herpes Zoster (HZ), caused by the reactivation of the latent Varicella Zoster Virus infection is a disease that may rarely develop in childhood. HZ is considered to be a disease of adult, but recent reports show an increase in the number of cases in childhood. This study was designed to evaluate the demographic and clinical features of children with HZ. Data from patients under 18 years of age that were diagnosed with HZ at two different dermatology outpatient clinics were retrospectively evaluated between October 2012 and December 2018. Out of 60 cases enrolled in the study, 37 were male and 23 were female. The mean age of patients was 8 ± 4.93 years. Of all the cases, 46 had a history of chickenpox. Three patients had been vaccinated against chickenpox. Itching, observed in 48 subjects, was the most common symptom, while 38 subjects complained of pain. Acyclovir was prescribed as antiviral therapy in 33 cases. None of the cases showed any complication. HZ may occur in healthy children without any immunosuppression, too. Pain in children is less common than in adults whereas, itching is more frequent. Complications are rare in these subjects.


Assuntos
Antivirais/administração & dosagem , Vacina contra Varicela/administração & dosagem , Varicela/complicações , Herpes Zoster/epidemiologia , Aciclovir/administração & dosagem , Adolescente , Criança , Pré-Escolar , Feminino , Herpes Zoster/diagnóstico , Humanos , Lactente , Masculino , Estudos Retrospectivos
19.
BMJ Case Rep ; 12(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31413050

RESUMO

Herpes simplex virus (HSV) encephalitis affects 2-4 people per million/year. Immunocompomised patients can have atypical presentations of HSV encephalitis, including a lack of cerebrospinal fluid (CSF) pleocytosis. We present the case of a patient who was receiving ustekinumab therapy for psoriasis which inhibits interleukin (IL)-12 and IL-23 signalling pathways. The initial presentation was suggestive of encephalitis, but he was discharged prior to the reporting of HSV positivity due to the lack of CSF pleocytosis. On representation, he had worsening symptoms and imaging showed midline shift, indicating cerebral oedema despite the immunosupressant effects of ustekinumab. He required intensive care unit support and treatment with high dose aciclovir and dexamethasone; after a month of treatment he made a good recovery. This case is the first to report a link between ustekinumab and HSV encephalitis, and also emphasises that imunocompromised patients can lack CSF pleocytosis and develop significant cerebral oedema which responds to immune suppression.


Assuntos
Anti-Inflamatórios/uso terapêutico , Edema Encefálico/diagnóstico , Fármacos Dermatológicos/efeitos adversos , Encefalite por Herpes Simples/diagnóstico , Hospedeiro Imunocomprometido , Ustekinumab/efeitos adversos , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Adulto , Anti-Inflamatórios/administração & dosagem , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Edema Encefálico/induzido quimicamente , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/tratamento farmacológico , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Diagnóstico Diferencial , Encefalite por Herpes Simples/líquido cefalorraquidiano , Encefalite por Herpes Simples/induzido quimicamente , Encefalite por Herpes Simples/tratamento farmacológico , Humanos , Masculino , Psoríase/tratamento farmacológico
20.
Sci Adv ; 5(8): eaax0780, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31453334

RESUMO

Current drug-delivery systems are designed primarily for parenteral applications and are either lipid or polymer drug conjugates. In our quest to inhibit herpes simplex virus infection via the compounds found in commonly used cosmetic products, we found that activated carbon particles inhibit infection and, in addition, substantially improve topical delivery and, hence, the efficacy of a common antiviral drug, acyclovir (ACV). Our in vitro studies demonstrate that highly porous carbon structures trapped virions, blocked infection and substantially improved efficacy when ACV was loaded onto them. Also, using murine models of corneal and genital herpes infections, we show that the topical use of drug-encapsulated carbon (DECON) reduced dosing frequency, shortened treatment duration, and exhibited higher therapeutic efficacy than currently approved topical or systemic antivirals alone. DECON is a nontoxic, cost-effective and nonimmunogenic alternative to current topical drug-delivery systems that is uniquely triggered for drug release by virus trapping.


Assuntos
Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Doenças da Córnea/tratamento farmacológico , Portadores de Fármacos/uso terapêutico , Herpes Genital/tratamento farmacológico , Herpesvirus Humano 1/efeitos dos fármacos , Animais , Antivirais/administração & dosagem , Células CHO , Carbono/química , Linhagem Celular Tumoral , Carvão Vegetal/química , Chlorocebus aethiops , Doenças da Córnea/virologia , Cricetulus , Modelos Animais de Doenças , Feminino , Células HeLa , Herpes Genital/virologia , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Células Vero
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