Successful foscarnet therapy for mucocutaneous infection with herpes simplex virus in a recipient after unrelated bone marrow transplantation.
A 36-year-old Japanese man who received an unrelated bone marrow transplant (BMT) developed severe mucocutaneous infection with herpes simplex virus (HSV) type 1 during oral acyclovir prophylaxis. The lesions progressed despite treatment with intravenous acyclovir and vidarabine. The HSV isolates were sensitive acyclovir, vidarabine and foscarnet in vitro, but peripheral CD3- or CD19-positive cells were barely detectable even 4 months after transplant. A 12-day course of treatment with foscarnet led to a rapid improvement. Foscarnet therapy should be considered for all severe HSV infections following BMT, regardless of whether or not the HSV isolates are sensitive to acyclovir.
Iino
T
T
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Japan.
Gondo
H
H
Ohno
Y
Y
Minagawa
H
H
Iwasaki
H
H
Maruyama
T
T
Nakashima
H
H
Niho
Y
Y
D000212:Acyclovir / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D004352:Drug Resistance, Microbial; D017245:Foscarnet / Q000494:pharmacology / Q000627:therapeutic use*; D006560:Herpes Labialis / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D015465:Leukemia, Myeloid, Accelerated Phase / Q000628:therapy; D008297:Male; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D018139:Simplexvirus / Q000187:drug effects / Q000302:isolation & purification; D013283:Stomatitis, Herpetic / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000494:pharmacology / Q000627:therapeutic use; D014916:Whole-Body Irradiation / Q000009:adverse effects
D000998:Antiviral Agents; D017245:Foscarnet; D014740:Vidarabine; D000212:Acyclovir