Successful foscarnet therapy for acyclovir-resistant mucocutaneous infection with herpes simplex virus in a recipient of allogeneic BMT.
A 41-year-old recipient of matched unrelated BMT acquired a severe mucocutaneous herpes simplex virus (HSV) type I infection during acyclovir prophylaxis. He was subsequently treated with high-dose acyclovir, but the HSV infection continued. In vitro analysis of the HSV isolate, obtained before and after the administration of high-dose acyclovir, demonstrated marked resistance to acyclovir but sensitivity to the antiviral agent foscarnet. The mucocutaneous HSV infection healed completely to a 16 day course of foscarnet. However, relapse of the acyclovir-resistant HSV infection occurred 202 days after the first foscarnet treatment but he responded again to a second foscarnet course. These data indicate that, with the rising frequency of acyclovir-resistant HSV infections observed in immunocompromised hosts, viral isolates should be tested for susceptibility to different antiviral drugs in recipients of BMT with recurrent or persistent HSV infections.
Verdonck
L F
LF
Department of Haematology, University Hospital Utrecht, The Netherlands.
Cornelissen
J J
JJ
Smit
J
J
Lepoutre
J
J
de Gast
G C
GC
Dekker
A W
AW
Rozenberg-Arska
M
M
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000818:Animals; D016026:Bone Marrow Transplantation; D002522:Chlorocebus aethiops; D004941:Esophagitis / Q000188:drug therapy / Q000382:microbiology; D017245:Foscarnet / Q000627:therapeutic use*; D006561:Herpes Simplex / Q000188:drug therapy*; D006801:Humans; D008297:Male; D012008:Recurrence; D018139:Simplexvirus / Q000187:drug effects; D014184:Transplantation, Homologous; D014709:Vero Cells / Q000382:microbiology
D017245:Foscarnet; D000212:Acyclovir