Herpes zoster encephalopathy or acyclovir neurotoxicity: a management dilemma.
This is a case report of a 69-year-old morbidly obese woman who presented with mental status changes after she was treated with acyclovir for shingles. The predominant symptoms were word-finding difficulties and visual hallucinations. Complicating her presentation was acyclovir-induced acute renal injury causing her creatinine level to rise up to 7.4 mg/dL. Acyclovir was discontinued on the suspicion of acyclovir neurotoxicity. Even though PCR for varicella zoster virus in the cerebrospinal fluid was positive, acyclovir was not restarted and the patient continued to improve and returned to her baseline.
Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA.
Daniel
D
Sacchetti
Aydah
A
Alawadhi
Mustafa
M
Albakour
Alwyn
A
Rapose
D058186:Acute Kidney Injury / Q000139:chemically induced; D000212:Acyclovir / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000821:virology; D020804:Encephalitis, Varicella Zoster / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D005260:Female; D006212:Hallucinations / Q000139:chemically induced*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications; D013064:Speech Disorders / Q000139:chemically induced*
D000998:Antiviral Agents; D000212:Acyclovir