title: Acyclovir-resistant herpes simplex virus pneumonia post-unrelated stem cell transplantation: a word of caution.
abstract: HSV causes serious complications in immunocompromised patients, especially SCT recipients. Although ACV is an effective antiviral prophylaxis, the emergence of ACV resistance is a growing problem. The authors describe two cases of fatal ACV-resistant HSV in two pediatric patients following unrelated donor SCT. Despite the in vitro sensitivity of the HSV isolates to foscarnet, both patients failed to respond to foscarnet therapy. Other antiviral therapies should be considered in those patients who fail to show rapid clinical improvement.
authors.affiliation: Pediatric Stem Cell Transplant Program, Vanderbilt Children's Hospital, Nashville, TN 37232, USA. haydar.frangoul@vanderbilt.edu
authors.forename: Haydar
authors.initials: H
authors.lastname: Frangoul
authors.forename: Marcia
authors.initials: M
authors.lastname: Wills
authors.forename: Christine
authors.initials: C
authors.lastname: Crossno
authors.forename: Michael
authors.initials: M
authors.lastname: Engel
authors.forename: Jennifer
authors.initials: J
authors.lastname: Domm
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D024882:Drug Resistance, Viral; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D011024:Pneumonia, Viral / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery*; D033581:Stem Cell Transplantation / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir