title: Differential diagnosis of central nervous system involvement in a patient treated with acyclovir.
abstract: Acyclovir-induced neuropsychiatric symptoms (AINSs) may resemble several diseases of the central nervous system. Laboratory testing of acyclovir may be critical in supporting the diagnosis of AINSs when there is doubt. We present a case of suspected herpes encephalitis in which the diagnosis of AINSs was supported by therapeutic drug monitoring of plasma and cerebrospinal fluid concentrations of acyclovir and its main metabolite 9-carboxymethoxymethylguanine.
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mia
authors.initials: M
authors.lastname: von Euler
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Axelsson
authors.forename: Anders
authors.initials: A
authors.lastname: Helldén
mesh_terms: D000212:Acyclovir / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D002490:Central Nervous System / Q000187:drug effects; D003937:Diagnosis, Differential; D016903:Drug Monitoring; D020803:Encephalitis, Herpes Simplex / Q000188:drug therapy; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis*; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir