Failure of antiviral therapy for acquired immunodeficiency syndrome-related cytomegalovirus myelitis.
We report the first published case (to our knowledge) of histopathologically documented acquired immunodeficiency syndrome-related cytomegalovirus (CMV) myelitis in which antiviral drug therapy was administered. Despite sensitivity of the patient's CMV isolate to therapy with both ganciclovir and foscarnet, use of neither of these agents halted progression of central nervous system CMV disease. Higher doses of these drugs or combination therapy may be required to treat acquired immunodeficiency syndrome-related CMV myelitis effectively.
Jacobson
M A
MA
Department of Medicine, University of California, San Francisco.
Mills
J
J
Rush
J
J
O'Donnell
J J
JJ
Miller
R G
RG
Greco
C
C
Gonzales
M F
MF
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000212:Acyclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000188:drug therapy; D004679:Encephalomyelitis / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D017245:Foscarnet; D015774:Ganciclovir; D006801:Humans; D008297:Male; D009943:Organophosphorus Compounds / Q000627:therapeutic use*; D010746:Phosphonoacetic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use*
D000998:Antiviral Agents; D009943:Organophosphorus Compounds; D017245:Foscarnet; D010746:Phosphonoacetic Acid; D015774:Ganciclovir; D000212:Acyclovir