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2.
Gastroenterology ; 157(4): e8-e9, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31476298
4.
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
5.
Indian J Med Microbiol ; 37(1): 120-122, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31424023

RESUMO

Primary amoebic meningoencephalitis is rare but fatal disease encountered in immunocompetent individuals. Here, we present a case of a previously healthy 8-month-old female child, who presented with features of meningoencephalitis of 2 days' duration. Rapidly moving trophozoites of amoeba were observed in cerebrospinal fluid, which were confirmed to be Naegleria fowleri on polymerase chain reaction. Broad-spectrum antimicrobial therapy with ceftriaxone, vancomycin, amphotericin B and acyclovir was initiated. However, the patient deteriorated and left the hospital against medical advice. The isolation of N. fowleri in this case demands for increased awareness for prompt diagnosis and management in view of its high mortality.


Assuntos
Amebíase/diagnóstico , Amebicidas/uso terapêutico , Infecções Protozoárias do Sistema Nervoso Central/diagnóstico , Meningoencefalite/parasitologia , Naegleria fowleri/isolamento & purificação , Aciclovir/uso terapêutico , Amebíase/tratamento farmacológico , Anfotericina B/uso terapêutico , Ceftriaxona/uso terapêutico , Infecções Protozoárias do Sistema Nervoso Central/tratamento farmacológico , Infecções Protozoárias do Sistema Nervoso Central/parasitologia , Líquido Cefalorraquidiano/parasitologia , Feminino , Humanos , Lactente , Meningoencefalite/diagnóstico , Meningoencefalite/tratamento farmacológico , Naegleria fowleri/genética , Trofozoítos/isolamento & purificação , Vancomicina/uso terapêutico
6.
BMJ Case Rep ; 12(8)2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31439560

RESUMO

This case describes an uncommon presentation of herpes zoster in an adolescent with viral meningitis and concomitant genital shingles. A 15-year-old immunocompetent girl with background of well-controlled Graves' disease presented with 3 days of fever, frontal headache, terminal neck stiffness and photophobia. This was preceded by 4 days of pain and itch over vaginal and anal region. She had one dose of varicella vaccination at 18 months old and developed mild primary varicella infection around 5 years of age. Varicella zoster virus DNA was detected both in cerebrospinal fluid and in vesicles over her right labial majora. While there is no international consensus on the recommended duration of treatment for zoster with neurological complications, she was treated with intravenous acyclovir for 10 days with good clinical response. Her fever, headache and neck stiffness resolved after 2 days and genital lesions resolved after 9 days of antiviral therapy.


Assuntos
Doença de Graves , Herpes Zoster/diagnóstico , Herpesvirus Humano 3/isolamento & purificação , Meningite Viral/diagnóstico , Infecção pelo Vírus da Varicela-Zoster/diagnóstico , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Adolescente , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Diagnóstico Diferencial , Feminino , Genitália , Herpes Zoster/complicações , Herpes Zoster/tratamento farmacológico , Humanos , Meningite Viral/complicações , Meningite Viral/tratamento farmacológico , Infecção pelo Vírus da Varicela-Zoster/complicações , Infecção pelo Vírus da Varicela-Zoster/tratamento farmacológico
7.
S D Med ; 72(8): 344-347, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31465638

RESUMO

Herpes simplex (HS) is an opportunistic infection, primarily in immunocompromised patients, caused by herpes simplex virus. Oral and genital mucosa are the most commonly involved sites; it is rare for HSV to invade the esophagus and cause esophagitis, especially in immunocompetent patients. Here, we present a case where an immunocompetent patient presented with HS esophagitis, which had evolved into esophageal ulcers. He was successfully treated with acyclovir. Subsequently, we did a comprehensive literature search and tabulated all the possible complications and management plans of previously reported cases of HS in immunocompetent patients.


Assuntos
Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Esofagite , Herpes Simples , Esofagite/tratamento farmacológico , Esofagite/virologia , Humanos , Masculino
8.
Medicine (Baltimore) ; 98(35): e17001, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464954

RESUMO

RATIONALE: Acute retinal necrosis (ARN), which is characterized by peripheral necrotizing retinitis, severe retinal arteritis, and progressive inflammatory reaction in the vitreous and anterior chambers, has been reported in cases with herpes simplex encephalitis (HSE). It is a relatively rare complication secondary to HSE. However, cases presented with viral encephalitis following ARN were seldom reported. PATIENT CONCERNS: A 43-year-old immunocompetent male patient manifested the aforesaid reverse situation. He developed HSE following 3-day systemic steroid therapy for abrupt ocular pain and rapidly decreased visual acuity, which was later diagnosed as ARN. Polymerase chain reaction (PCR) analysis of vitreous specimen verified herpes simplex virus-1 (HSV-1) infection. DIAGNOSIS: HSE associated with ARN. INTERVENTIONS: The patient was treated with intravenous acyclovir (500 mg every 8 h) for 21 days. A pulse of intravenous methylprednisolone, 500 mg/d for 5 days was given as an anti-inflammatory therapy, followed by prednisone taper. OUTCOMES: The patient's neurological symptoms got improved very soon after the therapy, but his vision acuity remained no perception of light in both eyes. LESSONS: The present case indicates that ARN can also be a risk factor for HSE. Once ARN was suspected, corticosteroid should be applied with caution and in combination with antiviral treatment to avoid progressive duplication of virus and its spread to the brain.


Assuntos
Encefalite por Herpes Simples/complicações , Herpesvirus Humano 1 , Síndrome de Necrose Retiniana Aguda/complicações , Aciclovir/uso terapêutico , Adulto , Anti-Inflamatórios/uso terapêutico , Antivirais/uso terapêutico , DNA Viral/análise , Encefalite por Herpes Simples/diagnóstico , Encefalite por Herpes Simples/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Masculino , Metilprednisolona/uso terapêutico , Reação em Cadeia da Polimerase , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico
10.
BMJ Case Rep ; 12(7)2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31337628

RESUMO

A 75-year-old woman presented with new onset of confusion, intense episodic dizziness and formed visual hallucinations. Herpes simplex encephalitis and non-convulsive temporal lobe seizures were confirmed with cerebrospinal fluid (CSF) and electroencephalography testing. In addition, her hospital course was complicated by syndrome of inappropriate antidiuretic hormone secretion and atonic bladder contributing to an episode of urinary tract infection. After completing 3 weeks of acyclovir treatment, the patient became obtunded with right arm choreiform movements and persistent inflammatory CSF findings not attributable to persistent herpes simplex virus infection or other confounding factors. The patient responded to steroid treatment. Repeated autoimmune and paraneoplastic evaluations were negative. Both clinical (cognitive testing and atonic bladder) and CSF inflammatory finding improved in the follow-up period.


Assuntos
Encefalite por Herpes Simples/diagnóstico , Encefalite/diagnóstico , Aciclovir/uso terapêutico , Idoso , Antivirais/uso terapêutico , Coreia/etiologia , Eletroencefalografia , Encefalite/líquido cefalorraquidiano , Encefalite/tratamento farmacológico , Encefalite/etiologia , Encefalite por Herpes Simples/líquido cefalorraquidiano , Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Síndrome de Secreção Inadequada de HAD/complicações , Metilprednisolona/uso terapêutico , Convulsões/etiologia , Bexiga Inativa/complicações , Retenção Urinária/complicações , Infecções Urinárias/complicações
11.
BMJ Case Rep ; 12(7)2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31326904

RESUMO

Bilateral independent periodic lateralised epileptiform discharges (BIPLEDs) in electroencephalograms (EEGs) are commonly caused by anoxic encephalopathy and central nervous system infections. They are associated with coma and high mortality and are thus markers of poor prognosis. We present a case of encephalitis who presented with BIPLEDs in EEG. Though the clinical, EEG and MRI features closely resembled herpes simplex encephalitis, further investigations proved it to be Epstein-Barr virus (EBV) encephalitis. Despite the presence of BIPLEDs in the EEG, the patient had a rapid clinical response to therapy with acyclovir. We emphasise that BIPLEDs may not always indicate poor prognosis especially in the setting of EBV encephalitis.


Assuntos
Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Encefalite Viral/virologia , Herpesvirus Humano 4/isolamento & purificação , Convulsões/virologia , Adulto , Diagnóstico Diferencial , Eletroencefalografia , Encefalite Viral/diagnóstico , Encefalite Viral/tratamento farmacológico , Humanos , Imagem por Ressonância Magnética , Masculino , Convulsões/diagnóstico , Convulsões/tratamento farmacológico
12.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31345997

RESUMO

OBJECTIVES: Neonatal herpes simplex virus (HSV) infections are associated with high mortality and long-term morbidity. However, incidence is low and acyclovir, the treatment of choice, carries risk of toxicity. We aimed to increase the percentage of patients 0 to 60 days of age who are tested and treated for HSV in accordance with local guideline recommendations from 40% to 80%. METHODS: This quality improvement project took place at 1 freestanding children's hospital. Multiple plan-do-study-act cycles were focused on interventions aimed at key drivers including provider buy-in, guideline availability, and accurate identification of high-risk patients. A run chart was used to track the effect of interventions on the percentage managed per guideline recommendations over time by using established rules for determining special cause. Pre- and postimplementation acyclovir use was compared by using a χ2 test. In HSV-positive cases, delayed acyclovir initiation, defined as >1 day from presentation, was tracked as a balancing measure. RESULTS: The median percentage of patients managed according to guideline recommendations increased from 40% to 80% within 8 months. Acyclovir use decreased from 26% to 7.9% (P < .001) in non-high-risk patients but did not change significantly in high-risk patients (73%-83%; P = .15). There were no cases of delayed acyclovir initiation in HSV-positive cases. CONCLUSIONS: Point-of-care availability of an evidence-based guideline and interventions targeted at provider engagement improved adherence to a new guideline for neonatal HSV management and decreased acyclovir use in non-high-risk infants. Further study is necessary to confirm the safety of these recommendations in other settings.


Assuntos
Herpes Simples/diagnóstico , Herpes Simples/terapia , Hospitais Pediátricos/normas , Guias de Prática Clínica como Assunto/normas , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/terapia , Melhoria de Qualidade/normas , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
13.
BMC Infect Dis ; 19(1): 625, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307420

RESUMO

BACKGROUND: Visceral disseminated varicella zoster virus (VDVZV) infection is a rare disease with a high mortality rate (55%) in immunocompromised patients, but it is not yet widely recognized in the field of nephrology. We report a case of VDVZV contracted during immunosuppressive therapy for membranous nephropathy. CASE PRESENTATION: A 36-year-old woman was diagnosed with membranous nephropathy and was being treated with immunosuppressive therapy consisting of 60 mg/day prednisolone, 150 mg/day mizoribine, and 150 mg/day cyclosporine. Nephrosis eased; therefore, the prednisolone dosage was reduced. However, 50 days after starting immunosuppressive therapy, the patient suddenly developed strong and spontaneous abdominal pain, predominantly in the epigastric area, without muscular guarding or rebound tenderness. Blood data indicated neutrophil-dominant elevated white blood cell count, reduced platelet count, elevated transaminase and lactate dehydrogenase, slightly increased C-reactive protein, and enhanced coagulability. Abdominal computed tomography revealed a mildly increased enhancement around the root of the superior mesenteric artery with no perforation, intestinal obstruction, or thrombosis. The cause of the abdominal pain was unknown, so the patient was carefully monitored and antibiotic agents and opioid analgesics administered. The following day, blisters appeared on the patient's skin, which were diagnosed as varicella. There was a marked increase in the blood concentration of VZV-DNA; therefore, the cause of the abdominal pain was diagnosed as VDVZV. Treatment with acyclovir and immunoglobulin was immediately started, and the immunosuppressive therapy dose reduced. The abdominal pain resolved rapidly, and the patient was discharged 1 week after symptom onset. DISCUSSIONS AND CONCLUSIONS: This patient was VZV-IgG positive, but developed VDVZV due to reinfection. Abdominal pain due to VDVZV precedes the skin rash, which makes it difficult to diagnose before the appearance of the rash, but measuring the VZV-DNA concentration in the blood may be effective. Saving the patient's life requires urgent administration of sufficient doses of acyclovir and reduced immunosuppressive therapy.


Assuntos
Glomerulonefrite Membranosa/diagnóstico , Herpesvirus Humano 3/isolamento & purificação , Infecção pelo Vírus da Varicela-Zoster/diagnóstico , Dor Abdominal/etiologia , Aciclovir/uso terapêutico , Adulto , Antivirais/uso terapêutico , Contagem de Células Sanguíneas , DNA Viral/sangue , Feminino , Glomerulonefrite Membranosa/complicações , Glomerulonefrite Membranosa/tratamento farmacológico , Herpesvirus Humano 3/genética , Humanos , Imunoglobulinas/uso terapêutico , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Tomografia Computadorizada por Raios X , Infecção pelo Vírus da Varicela-Zoster/complicações , Infecção pelo Vírus da Varicela-Zoster/tratamento farmacológico
14.
Medicine (Baltimore) ; 98(30): e16591, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348301

RESUMO

RATIONALE: Epithelial keratitis is a common complication after cataract surgery. Many factors have been attributed to this clinical phenomenon. PATIENT CONCERNS: An 82-year-old woman without previous herpes simplex keratitis (HSK) underwent an uncomplicated clear corneal phacoemulsification procedure in the right eye. In the late postoperative period, epithelial keratitis developed in this same eye. DIAGNOSIS: An initial diagnosis of HSK was made clinically. The lesion was refractory to antiviral treatment and had progressed. After topical acyclovir cessation and vigorous lubrication, a diagnosis of toxic keratitis was finally made. OUTCOMES: The corneal epithelial defect and dendritic lesion presented initially. Responding to antiviral treatment, this corneal lesion aggravated and revealed large epithelial erosion. After topical acyclovir cessation and initiation of vigorous lubrication, the toxic keratitis was completely resolved. LESSONS: Epithelial keratitis following cataract surgery is a common complication and can be misdiagnosed early in its disease course. Physicians should be alert to the possibility of HSK. Polymerase chain reaction detection is helpful in diagnosing this disease.


Assuntos
Extração de Catarata/efeitos adversos , Ceratite Herpética/classificação , Ceratite Herpética/etiologia , Aciclovir/uso terapêutico , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Ceratite Herpética/diagnóstico , Ceratite Herpética/tratamento farmacológico
15.
Transplant Proc ; 51(7): 2350-2354, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31358453

RESUMO

BACKGROUND: The aim of the study was to evaluate the efficacy of a unique cytomegalovirus- (CMV) prophylaxis protocol in terms of CMV infection and disease progression in CMV IgG positive kidney transplant recipients. METHODS: Achievement of negative CMV load, using concurrent prophylactic intravenous ganciclovir therapy during induction immunosuppression, combined with a 6-month prophylactic course of acyclovir, would yield a reduced incidence of early CMV infection and disease. CMV DNA was tested for at discharge, at the third, and sixth post-op months, and at the occurrence of any event that could be associated with CMV infection. CMV DNA positive patients received ganciclovir treatment until the viral load became negative. CMV replication was monitored using a quantitative PCR method capable of detecting as few as 42.5 copies/mL. All patients were given a maintenance dose of acyclovir. RESULT: The file data of 267 patients who had undergone kidney transplantation between 2007 to 2016 were examined. Thirty-four patients were excluded from the study for various reasons, unrelated to the protocol. Of the remaining 233 patients, 42 (18%) had CMV DNA infection. Three patients had CMV disease (1.3%), 1of whom died of pneumonia. Diabetes mellitus (DM) was a risk factor for CMV DNA positivity (P < .004). CONCLUSION: The incidence of CMV infection and disease is low in renal transplant recipients whose CMV viral load is eliminated after concurrent ganciclovir administration with induction immunosuppression.


Assuntos
Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Infecções por Citomegalovirus/prevenção & controle , Ganciclovir/uso terapêutico , Transplante de Rim , Adulto , Citomegalovirus , Infecções por Citomegalovirus/epidemiologia , Feminino , Humanos , Incidência , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Transplantados , Carga Viral/efeitos dos fármacos
17.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31217310

RESUMO

Herpes simplex virus 1 and 2 infections affect up to 50 million people in the United States, with a natural history of recurrent viral shedding with or without recurrence of symptoms. Although many patients remain asymptomatic or with mild symptoms, a spectrum of rare but significant nervous system complications have been reported. Although urinary retention and constipation associated with genital herpesvirus infections is often attributed to painful genital ulcerations, herpesvirus-associated lumbosacral myeloradiculitis has been reported in adults. Here, we report an 18-year-old man with constipation, urinary retention, perineal paresthesias, and erectile dysfunction in the setting of a genital herpes infection. His workup was notable for a cerebrospinal fluid pleocytosis and MRI with enhancement of the cauda equina and nerve roots, all of which are consistent with sacral myeloradiculitis. The patient was treated with a 3-week course of intravenous acyclovir with complete resolution of symptoms. Pediatric practitioners should be aware of this complication of anogenital herpes simplex virus infection because appropriate diagnosis has implications for treatment delivery and duration.


Assuntos
Herpes Genital/complicações , Radiculopatia/virologia , Sacro/inervação , Aciclovir/uso terapêutico , Adolescente , Antivirais/uso terapêutico , Constipação Intestinal/virologia , Herpes Genital/tratamento farmacológico , Humanos , Masculino , Neuralgia/virologia , Parestesia/virologia , Retenção Urinária/virologia
18.
J Clin Neurosci ; 67: 265-270, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31239199

RESUMO

Acute hemorrhagic leukoencephalitis (AHL) is a rare and mostly fatal fulminant demyelinating disease. This case describes a 63-year old male in status epilepticus associated with an intracerebral hemorrhage following a one week viral prodrome with rapid decline to coma. He exhibited peripheral leukocytosis, neutrophilic pleocytosis with normal glucose and high protein in cerebrospinal fluid (CSF). Additionally, CSF was positive for herpes simplex virus (HSV) polymerase chain reaction (PCR). Medical decompression, low-dose dexamethasone, antibiotics and acyclovir were initially given. Magnetic resonance imaging (MRI) was suggestive of AHL, thus he was treated with methylprednisolone 1 g/day for 5 days. The patient improved and was discharged with significant neurologic morbidity. This is the first reported case of AHL in the Philippines presenting as a diagnostic dilemma with a protracted clinical course who responded to high dose intravenous steroids.


Assuntos
Encefalite por Herpes Simples/diagnóstico , Leucoencefalite Hemorrágica Aguda/diagnóstico , Estado Epiléptico/diagnóstico , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Diagnóstico Diferencial , Encefalite por Herpes Simples/complicações , Humanos , Leucoencefalite Hemorrágica Aguda/etiologia , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Fármacos Neuroprotetores/uso terapêutico , Estado Epiléptico/tratamento farmacológico , Estado Epiléptico/etiologia
19.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(5): 393-397, jun. 2019. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-180928

RESUMO

Las infecciones por virus herpes presentan una frecuencia no desdeñable en pacientes hematológicos. El primer caso corresponde a una paciente con leucemia linfática crónica con un herpes genital extenso refractario a aciclovir, con respuesta parcial a foscarnet que hubo que suspender por efectos secundarios sistémicos. El segundo caso es el de una paciente con un linfoma de Hodgkin folicular que presentaba un herpes hipertrófico refractario a tratamiento con aciclovir, que respondió a cidofovir intralesional e imiquimod tópico. Los pacientes hematológicos, al igual que otros enfermos inmunodeprimidos, pueden presentar manifestaciones atípicas de infección por virus herpes, así como resistencia a los tratamientos que actúan por medio de la timidina quinasa viral. Esto hace necesario tener una alta sospecha clínica para poder alcanzar un diagnóstico precoz, y conocer los diferentes tratamientos alternativos disponibles


Herpesvirus infections are not uncommon in hematologic patients. Our first patient, diagnosed with chronic lymphatic leukemia, presented extensive genital herpes infection refractory to treatment with aciclovir and with a partial response to foscarnet, which had to be withdrawn due to systemic adverse effects. The second patient, diagnosed with follicular Hodgkin lymphoma, presented hypertrophic herpes infection refractory to treatment with aciclovir but that responded to intralesional cidofovir and topical imiquimod. As in other immunocompromised patients, herpesvirus infection in hematologic patients can present atypical manifestations, as well as resistance to treatments that are activated by the viral thymidine kinase. A high level of clinical suspicion is therefore needed to make an early diagnosis, together with extensive knowledge of the different treatments available


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Herpes Simples/tratamento farmacológico , Infecções por Herpesviridae/tratamento farmacológico , Aciclovir/administração & dosagem , Farmacorresistência Viral , Herpesvirus Humano 2/patogenicidade , Herpes Simples/diagnóstico , Infecções por Herpesviridae/diagnóstico , Aciclovir/uso terapêutico , Foscarnet/administração & dosagem , Herpesviridae/patogenicidade , Foscarnet/efeitos adversos , Diagnóstico Diferencial
20.
Skinmed ; 17(2): 96-98, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31145058

RESUMO

Clinical diagnosis of Herpes simplex-infected pemphigus erosions is challenging. Pemphigus and Herpes simplex both produce superficial erosions on the skin and mucosa after rupture of vesicles or bullae. Delay in diagnosis of herpes-infected pemphigus patients often causes prolonged morbidity. So far, there has been a paucity of literature describing the characteristic features of Herpes simplex-infected pemphigus erosions. In the present case series, we have illustrated the morphologic features of three Herpes simplex-infected pemphigus erosions and also have suggested characteristic clinical features that were consistently present in all cases.


Assuntos
Herpes Simples/complicações , Herpes Simples/diagnóstico , Pênfigo/virologia , Aciclovir/uso terapêutico , Adulto , Antivirais/uso terapêutico , Progressão da Doença , Feminino , Herpes Simples/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade
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