[Cerebral and renal toxicity of acyclovir in a patient treated for meningoencephalitis].
We report the case of a 65-year-old man treated with intravenous acyclovir and amoxicilline for meningoencephalitis. Six days later, he suddenly developed acute renal failure, associated with central nervous system symptoms. The high acyclovir concentration in plasma and spinal fluid confirmed the hypothesis of acyclovir toxicity. Continuous haemofiltration resulted in a rapid amendment of neurologic and renal symptoms. Despite the high therapeutic index of acyclovir, manifestations of neurotoxicity and nephrotoxicity are not a rare event. The risk is increased in the elderly and in patients with renal insufficiency. Rapid intravenous injections are contraindicated. Continuous haemofiltration is rapidly efficient. The value of acyclovir concentration determination in plasma and spinal fluid are stressed.
Da Conceiçao
M
M
Service de réanimation polyvalente, HIA Legouest, Metz Armée, France.
Genco
G
G
Favier
J C
JC
Verrot
D
D
Pitti
R
R
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000212:Acyclovir / Q000009:adverse effects*; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000188:drug therapy*
D000998:Antiviral Agents; D000212:Acyclovir