Intravenous foscarnet in the management of acyclovir-resistant herpes simplex virus type 2 in acute retinal necrosis in children.
BACKGROUND
Diagnosis and management of Acute Retinal Necrosis (ARN) in children that does not respond to systemic acyclovir treatment can be challenging. We report two cases of ARN secondary to herpes simplex virus (HSV) type 2 that was resistant to acyclovir but was treated successfully with intravenous foscarnet.


METHODS
Two children diagnosed with ARN failed to show clinical response to systemic acyclovir treatment. Both cases had histories of previous HSV infections and vitreous taps positive for HSV-2. Both were converted to systemic foscarnet treatment with successful control of the retinitis and satisfactory visual outcomes.


CONCLUSIONS
Systemic foscarnet can be effective in the management of pediatric acute retinal necrosis caused by HSV-2 when there is an atypical response to conventional acyclovir treatment.
Khurana
Rahul N
RN
Children's Retina Institute of California, Glendale, CA, USA.
Charonis
Alexander
A
Samuel
Michael A
MA
Gupta
Anurag
A
Tawansy
Khaled A
KA
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D024882:Drug Resistance, Viral; D005260:Female; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use*; D006561:Herpes Simplex / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D018258:Herpesvirus 2, Human / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D015882:Retinal Necrosis Syndrome, Acute / Q000188:drug therapy* / Q000473:pathology / Q000821:virology
D000998:Antiviral Agents; D017245:Foscarnet; D000212:Acyclovir