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Sample records for acyclovir

  1. Acyclovir Topical

    ... should only be applied to skin where a cold sore has formed or seems likely to form. Do not apply acyclovir cream to any unaffected ... of cream to cover the skin where the cold sore has formed or seems likely to form. Rub the cream into the skin until it ...

  2. Acyclovir-induced colitis.

    Wardle, T D; Finnerty, J P; Swale, V; Beer, T

    1997-04-01

    Three patients developed acute colitis, either de novo, or as an exacerbation of pre-existing colitis, following the use of oral acyclovir, prescribed for Herpes zoster or Herpes simplex infection. Rechallenge with oral acyclovir was performed in one patient, and resulted in a recurrence of colitic symptoms. It is speculated that acyclovir can have a direct irritant effect on large bowel mucosa. PMID:9146784

  3. Oral acyclovir (Zovirax) in herpes simplex dendritic corneal ulceration.

    Collum, L M; McGettrick, P.; Akhtar, J.; Lavin, J.; Rees, P J

    1986-01-01

    Sixty patients with simple dendritic corneal ulceration were randomly assigned to double blind treatment with either acyclovir tablets (400 mg) or acyclovir ophthalmic ointment administered five times daily. There was no significant difference in the proportions of patients healed in either treatment group (88.9% on oral acyclovir and 96.6% on acyclovir ointment). The median healing time was five days in both groups. No systemic or significant local side effects were noted in either treatment...

  4. Topical therapy of recurrent herpes - acyclovir versus tromantidine

    Kumar Bhushan

    1991-01-01

    Full Text Available Fifty men with recurrent genital herpes were treated with either acyclovir 5% cream or tromantidine 1 % ointment applied topically. Acyclovir cream was applied 5 times and tromantidine cream 4 times daily for 5 days. At least one pre-treatment episode was observed by one of the authors. Self assessment charts were provided to the patients to record prodromal symptoms and healing time. For comparison at least 3 post treatment episodes were observed and com-pared with mean healing time of 3 pre-treatment episodes. Both acyclovir cream and tromantidine ointment significantly reduced the duration of prodrome, hastened healing and so reduced mean healing time.

  5. Colloidal dispersions for the delivery of acyclovir: A comparative study

    Rita Cortesi; Laura Ravani; Enea Menegatti; Drechsler, M.; Elisabetta Esposito

    2011-01-01

    This paper describes a comparative study on the performances of ethosomes and solid lipid nanoparticle as delivery systems for acyclovir. Ethosomes were spontaneously produced by dissolution of phosphatidylcholine and acyclovir in ethanol followed by addition of an aqueous buffer while solid lipid nanoparticle were produced by homogenization and ultrasonication. Both colloidal systems were morphologically characterized by cryo-transmission electron microscopy. The encapsulation efficiency was...

  6. Acyclovir prodrug for the intestinal di/tri-peptide transporter PEPT1

    Thomsen, Anne Engelbrecht; Christensen, Michael Søberg; Bagger, Morten Aavad;

    2004-01-01

    a measure for intracellular accumulation. In addition, bi-directional transport studies of Glu(acyclovir)-Sar across Caco-2 cell monolayers and in vitro metabolism studies of Glu(acyclovir)-Sar in various media of rat origin were performed. For these purposes HPLC-UV analysis was applied. Oral......(acyclovir)-Sar, acyclovir and valacyclovir were given to rats and the collected blood samples were analysed via LC-MS-MS. Furthermore, Caco-2 cell monolayers were exposed apically to Glu(acyclovir)-Sar, acyclovir, and valacyclovir and the concentration of drug and prodrugs in the cell extracts were determined and taken as...

  7. Colloidal dispersions for the delivery of acyclovir: A comparative study

    Rita Cortesi

    2011-01-01

    Full Text Available This paper describes a comparative study on the performances of ethosomes and solid lipid nanoparticle as delivery systems for acyclovir. Ethosomes were spontaneously produced by dissolution of phosphatidylcholine and acyclovir in ethanol followed by addition of an aqueous buffer while solid lipid nanoparticle were produced by homogenization and ultrasonication. Both colloidal systems were morphologically characterized by cryo-transmission electron microscopy. The encapsulation efficiency was 94.2±2.8% for ethosomes and 53.2±0.2% for solid lipid nanoparticle. Concerning Z potential, both formulations are close to neutrality. The diffusion coefficients of the drug from ethosomes and solid lipid nanoparticle, determined by a Franz cell method, were 9.4 and 1.2-fold lower as compared to the free acyclovir in solution, thus evidencing the ability of both colloidal systems in enhancing the diffusion of the drug. The antiviral activity against HSV-1 of both systems was tested by plaque reduction assay in monolayer cultures of Vero cells. Data showed that no significant differences in the antiviral activity were observed by acyclovir in the free or loaded forms. Taken together these results, colloidal systems could be interesting to mediate the penetration of acyclovir within Vero cells.

  8. Colloidal dispersions for the delivery of acyclovir: a comparative study.

    Cortesi, Rita; Ravani, Laura; Menegatti, Enea; Drechsler, M; Esposito, Elisabetta

    2011-11-01

    This paper describes a comparative study on the performances of ethosomes and solid lipid nanoparticle as delivery systems for acyclovir. Ethosomes were spontaneously produced by dissolution of phosphatidylcholine and acyclovir in ethanol followed by addition of an aqueous buffer while solid lipid nanoparticle were produced by homogenization and ultrasonication. Both colloidal systems were morphologically characterized by cryo-transmission electron microscopy. The encapsulation efficiency was 94.2±2.8% for ethosomes and 53.2±0.2% for solid lipid nanoparticle. Concerning Z potential, both formulations are close to neutrality. The diffusion coefficients of the drug from ethosomes and solid lipid nanoparticle, determined by a Franz cell method, were 9.4 and 1.2-fold lower as compared to the free acyclovir in solution, thus evidencing the ability of both colloidal systems in enhancing the diffusion of the drug. The antiviral activity against HSV-1 of both systems was tested by plaque reduction assay in monolayer cultures of Vero cells. Data showed that no significant differences in the antiviral activity were observed by acyclovir in the free or loaded forms. Taken together these results, colloidal systems could be interesting to mediate the penetration of acyclovir within Vero cells. PMID:23112407

  9. Improving oral bioavailability of acyclovir using nanoparticulates of thiolated xyloglucan.

    Madgulkar, Ashwini; Bhalekar, Mangesh R; Dikpati, Amrita A

    2016-08-01

    Acyclovir a BCS class III drug exhibits poor bioavailability due to limited permeability. The intention of this research work was to formulate and characterize thiolated xyloglucan polysaccharide nanoparticles (TH-NPs) of acyclovir with the purpose of increasing its oral bioavailability. Acyclovir-loaded TH-NPs were prepared using a cross-linking agent. Interactions of formulation excipients were reconnoitered using Fourier transform infrared spectroscopy (FT-IR). The formulated nanoparticles were lyophilised by the addition of a cryoprotectant and characterized for its particle size, morphology and stability and optimized using Box Behnken Design.The optimized TH-NP formulation exhibited particle size of 474.4±2.01 and an entrapment efficiency of 81.57%. A marked enhancement in the mucoadhesion was also observed. In-vivo study in a rat model proved that relative bioavailability of acyclovir TH-NPs is ∼2.575 fold greater than that of the marketed acyclovir drug suspension. PMID:27026342

  10. Acyclovir in the prevention of duodenal ulcer recurrence

    Rune, S J; Linde, J; Bonnevie, O;

    1990-01-01

    This study tests the hypothesis that reactivation of a latent herpes simplex virus infection may be a cause of recurrent duodenal ulceration. Patients with recently healed duodenal ulcer were entered into a double blind, randomised study of maintenance treatment with the antiviral drug acyclovir...... and at the end of the 25 week trial period. In the acyclovir group the cumulated relapse rate was 63% compared with 56% in the placebo group (NS). This result suggests that reactivation of herpes simplex virus is not a cause of recurrent duodenal ulcer....

  11. Should a hospitalized child receive empiric treatment with acyclovir?

    Kulik Dina M

    2012-12-01

    Full Text Available Abstract Background Herpes simplex encephalitis is associated with substantial morbidity and mortality and may be related to timely diagnosis and treatment. While awaiting the results of testing, hospitalization and empiric treatment with acyclovir is recommended, though the direct and indirect costs associated with this management are substantial. We sought to examine children hospitalized for possible herpes simplex encephalitis, following clinical and laboratory assessment in the emergency department, and empiric treatment with acyclovir, in order to describe the proportion receiving a complete course of treatment; and to identify the clinical variables which are associated with receiving a complete course, as compared with an incomplete course of acyclovir. Methods Hospitalized children prescribed acyclovir were included in this case control study. Clinical, laboratory and diagnostic variables were abstracted for children prescribed a complete (≥ 14 days or an incomplete course ( Results 289 children met eligibility criteria, 30 (10% received a complete course and 259 (90% received an incomplete course. A history of mucocutaneous herpes simplex virus infection (p  Conclusions Many children did not complete a full course of therapy. Unnecessary testing and treatment is burdensome to families and the health care system. Possible predictive variables include abnormal Glascow Coma Scale, focal neurologic findings and cerebrospinal fluid pleocytosis.

  12. Design and development of microemulsion drug delivery system of acyclovir for improvement of oral bioavailability

    Ghosh, Pradip Kumar; Majithiya, Rita J.; Umrethia, Manish L.; Murthy, Rayasa S. R.

    2006-01-01

    The main purpose of this work was to develop an oral microemulsion formulation for enhancing the bioavailability of acyclovir. A Labrafac-based microemulsion formulation with Labrasol as surfactant and Plurol Oleique as cosurfactant was developed for oral delivery of acyclovir. Phase behavior and solubilization capacity of the microemulsion system were characterized, and in vivo oral absorption of acyclovir from the microemulsion was investigated in rats. A single isotropic region, which was ...

  13. Topical distribution of acyclovir in normal equine skin and equine sarcoids: An in vitro study.

    Haspeslagh, M; Taevernier, L; Maes, A A; Vlaminck, L E M; De Spiegeleer, B; Croubels, S M; Martens, A M

    2016-06-01

    Topical acyclovir application is an owner-friendly treatment for occult equine sarcoids, without the caustic side-effects other topical treatments have. Variable clinical success rates have been described, but it is not known to what rate and extent acyclovir penetrates in and through equine skin from a topical formulation. In the current study, an in vitro Franz diffusion model was used to determine the permeation parameters for a generic 5% acyclovir cetomacrogol cream for both healthy and sarcoid equine skin. The distribution of acyclovir between different layers of both skin types was also evaluated. While acyclovir penetrated through both skin types, significantly less acyclovir permeated to the deep dermis of sarcoid skin (197.62ng/mm(3)) compared to normal skin (459.41ng/mm(3)). Within sarcoid skin samples, significantly higher acyclovir concentrations were found in the epidermis (983.59ng/mm(3)) compared to the superficial dermis (450.02ng/mm(3)) and the deep dermis. At each sample point, significantly more acyclovir permeated to the receptor fluid through normal skin compared to sarcoid skin, which is reflected in the significantly higher permeation parameters of normal skin. Normal skin was found to be more permissive for acyclovir, but even in sarcoid skin, enough acyclovir reached the deep dermis to treat a Herpes simplex virus infection. In the case of equine sarcoids, the treatment is aimed at the Bovine papillomavirus and no information is available on the susceptibility of the DNA polymerase of this virus for acyclovir. Therefore, further research is needed to determine the efficacy of acyclovir to treat equine sarcoids. PMID:27234546

  14. In vitro absorption studies of acyclovir using natural permeation enhancers

    Dias, Remeth J.; Mali, Kailas K.; Ghorpade, Vishwajeet S.; Garje, Sandeep B.; Havaldar, Vijay D.

    2010-01-01

    Gastroretentive Delivery Systems are employed to improve the bioavailability of drugs which are absorbed through upper part of GIT, by increasing their retention time. Incorporation of permeability enhancers in the formulations of such drugs can further increase their bioavailability; however their use in the formulations is questionable due to the toxicity exhibited by them. Acyclovir is a class III drug having low oral bioavailability due to improper absorption. Mucoadhesive tab...

  15. Design and Optimization of Floating Drug Delivery System of Acyclovir

    Kharia A; Hiremath S; Singhai A; Omray L; Jain S

    2010-01-01

    The purpose of the present work was to design and optimize floating drug delivery systems of acyclovir using psyllium husk and hydroxypropylmethylcellulose K4M as the polymers and sodium bicarbonate as a gas generating agent. The tablets were prepared by wet granulation method. A 32 full factorial design was used for optimization of drug release profile. The amount of psyllium husk (X1) and hydroxypropylmethylcellulose K4M (X2) were selected as independent variables. The times required for 50...

  16. Design of Nanoparticles Loaded Acyclovir for Controlled Delivery System

    Shadab Shahsavari; Farid Abedin Dorkoosh; Ebrahim Vasheghani Farahani; Mehdi Arjmand

    2015-01-01

    Introduction: The aim of this research was to develop a new drug release systems based on Nanoparticles. In this study, the natural polymer chitosan was used for preparation of nanoparticles due to its unique properties, such as biocompatibility and biodegradability. Methods: The polymeric nano-drug controlled release system has been designed with experimental design D-optimal response surface methodology, for varied variables such as the concentration of acyclovir, concentration ratio of...

  17. Alopecia following oral acyclovir for the treatment of herpes simplex keratitis

    Ashok Sharma

    2014-01-01

    Full Text Available The authors report acyclovir-induced alopecia in a patient treated for herpetic keratouveitis. A 32-years-old female was diagnosed with herpetic keratouveitis. She was placed on prednisolone acetate (1% suspension four times a day, atropine sulfate (1% thrice a day, and oral acyclovir 400 mg twice-daily. Three weeks following oral acylovir, keratouveitis improved, but she developed alopecia without any drug eruptions. Oral acyclovir was discontinued. Three months later, alopecia completely resolved. Alopecia may be considered a possible complication following oral acyclovir.

  18. Development and Evaluation of Gastro-Retentive Floating Acyclovir Tablets

    Girani S

    2015-12-01

    Full Text Available In the present study an attempt was made to prepare acyclovir floating tablets. Acyclovir floating tablets (200mg were prepared by direct compression method using HPMC, sodium carboxy methyl cellulose and carbopol with an effervescent base (sod. Bicarbonate and citric acid. FTIR study confirmed the absence of any drug/polymer/excipients interactions. The prepared floating tablets were evaluated for hardness, weight variation, thickness, friability, drug content uniformity, buoyancy lag time, total floating time, swelling index and in vitro dissolution studies. Among all the 12 formulations F1, F2, F3, F4, F5, F6, F10, F11, F12 showed good floating property while formulations F7, F8, F9 showed moderate floating while all the 12 formulations showed controlled drug release. Stability studies were carried out for F4 and F10, both the formulations showed good stability. It was observed that F4 and F10 gave maximum drug release upto 97.17% within 24 hrs.SEM study indicates that both the tablets F4 &F10 have smooth and uniform surface before the dissolution study, but after the dissolution study, the Tablet F4 which was prepared withsod.CMC has shown erosion of the polymer matrix. But the Tablet F10 have shown spongy like structure, the matrix was swollen and pores were created.

  19. Preparation and evaluation of gastroretentive floating tablets of acyclovir.

    Garg, Rajeev; Gupta, G D

    2009-10-01

    The present study performed by preparation and evaluation of floating tablets of Acyclovir as model drug for prolongation of gastric residence time. Floating effervescent tablets were formulated by various materials like hydroxypropyl methylcellulose K 4M, K 15M, psyllium husk, swelling agent as crospovidone and microcrystalline cellulose and gas generating agent like sodium bicarbonate and citric acid and evaluated for floating properties, swelling characteristics and in vitro drug release studies. Floating noneffervescent tablets were prepared by polypropylene foam powder and different matrix forming polymers like HPMC K 4M, Carbopol 934P, xanthan gum and sodium alginate. In vitro drug release studies were performed and drug release kinetics evaluated using the linear regression method was found to follow both the Higuchi and the Korsmeyer and Peppas equation. The drug release mechanism was found fickian type in most of the formulations. PMID:19751200

  20. Biphasic gastroretentive drug delivery system of acyclovir: formulation and in vitro evaluation

    Bandari, Suresh; Yamsani, Madhusudan R.

    2010-01-01

    A biphasic gastroretentive drug delivery system of acyclovir consisted of loading dose tablet and floating multiple matrix tablets was prepared by direct compression process. The delivery system was designed by hydroxy propyl methyl cellulose as retardant polymer with an effervescent component to get the desired buoyant and sustained release characteristics. All formulations compile within the limits. The FTIR studies did not show any evidence of an interaction between acyclovir a...

  1. Acyclovir-resistant herpetic keratitis in a solid-organ transplant recipient on systemic immunosuppression

    Turner LD

    2013-01-01

    Full Text Available Liam Daniel Turner,1 Peter Beckingsale1,2,31Princess Alexandra Hospital; 2Terrace Eye Centre; 3Laser Sight, Brisbane, Queensland, AustraliaPurpose: To report a case of acyclovir-resistant herpetic keratitis in a solid-organ lung transplant recipient that was effectively treated with topical trifluridine.Methods: A case of a 35-year-old female with herpetic epithelial keratitis resistant to acyclovir is described. The patient presented following treatment for 4 weeks with topical acyclovir ointment five times per day and oral valacyclovir 1 g three times per day for herpetic keratitis with no resolution of the epithelial defect or symptoms. Corneal scrapes and swabs were taken for confirmation of the diagnosis and resistance testing. The results were positive for herpes simplex virus 1 and showed acyclovir resistance (inhibitor concentration 90 = 200 µg/mL and foscarnet sensitivity (inhibitor concentration 90 = 200 µg/mL. The patient was treated with topical trifluridine 2-hourly for 3 weeks and weaned off the drops over the following week.Results: The patient showed resolution of the epithelial defect, but did have significant corneal toxicity associated with the use of the trifluridine. At 8 weeks, the patient had some stromal shadowing associated with the recent active infection, but symptoms had settled.Conclusion: This case documents the effective use of topical trifluridine in proven acyclovir-resistant herpetic keratitis. It highlights three things: (1 the importance of considering topical trifluridine as an alternative to topical acyclovir in unresponsive disease; (2 the need to consider solid-organ transplant recipients in the immunocompromised population with resistant herpetic disease, and (3 the need to look for alternatives to treatment of resistant herpetic disease.Keywords: acyclovir resistance, herpetic keratitis, trifluridine

  2. Design and optimization of floating drug delivery system of acyclovir

    Kharia A

    2010-01-01

    Full Text Available The purpose of the present work was to design and optimize floating drug delivery systems of acyclovir using psyllium husk and hydroxypropylmethylcellulose K4M as the polymers and sodium bicarbonate as a gas generating agent. The tablets were prepared by wet granulation method. A 32 full factorial design was used for optimization of drug release profile. The amount of psyllium husk (X1 and hydroxypropylmethylcellulose K4M (X2 were selected as independent variables. The times required for 50% (t 50% and 70% (t 70% drug dissolution were selected as dependent variables. All the designed nine batches of formulations were evaluated for hardness, friability, weight variation, drug content uniformity, swelling index, in vitro buoyancy, and in vitro drug release profile. All formulations had floating lag time below 3 min and constantly floated on dissolution medium for more than 24 h. Validity of the developed polynomial equation was verified by designing two check point formulations (C1 and C2. The closeness of predicted and observed values for t 50% and t 70% indicates validity of derived equations for the dependent variables. These studies indicated that the proper balance between psyllium husk and hydroxypropylmethylcellulose K4M can produce a drug dissolution profile similar to the predicted dissolution profile. The optimized formulations followed Higuchi′s kinetics while the drug release mechanism was found to be anomalous type, controlled by diffusion through the swollen matrix.

  3. Design and optimization of floating drug delivery system of acyclovir.

    Kharia, A A; Hiremath, S N; Singhai, A K; Omray, L K; Jain, S K

    2010-09-01

    The purpose of the present work was to design and optimize floating drug delivery systems of acyclovir using psyllium husk and hydroxypropylmethylcellulose K4M as the polymers and sodium bicarbonate as a gas generating agent. The tablets were prepared by wet granulation method. A 3(2) full factorial design was used for optimization of drug release profile. The amount of psyllium husk (X1) and hydroxypropylmethylcellulose K4M (X2) were selected as independent variables. The times required for 50% (t(50%)) and 70% (t(70%)) drug dissolution were selected as dependent variables. All the designed nine batches of formulations were evaluated for hardness, friability, weight variation, drug content uniformity, swelling index, in vitro buoyancy, and in vitro drug release profile. All formulations had floating lag time below 3 min and constantly floated on dissolution medium for more than 24 h. Validity of the developed polynomial equation was verified by designing two check point formulations (C1 and C2). The closeness of predicted and observed values for t(50%) and t(70%) indicates validity of derived equations for the dependent variables. These studies indicated that the proper balance between psyllium husk and hydroxypropylmethylcellulose K4M can produce a drug dissolution profile similar to the predicted dissolution profile. The optimized formulations followed Higuchi's kinetics while the drug release mechanism was found to be anomalous type, controlled by diffusion through the swollen matrix. PMID:21694992

  4. Polish consensus guidelines on the use of acyclovir in the treatment and prevention of VZV and HSV infections.

    Szenborn, Leszek; Kraszewska-Głomba, Barbara; Jackowska, Teresa; Duszczyk, Ewa; Majda-Stanisławska, Ewa; Marczyńska, Magdalena; Ołdak, Elżbieta; Pawłowska, Małgorzata; Służewski, Wojciech; Wysocki, Jacek; Stryczyńska-Kazubska, Joanna; Kuchar, Ernest

    2016-02-01

    A physician has to perform a benefit-risk assessment each time acyclovir is prescribed "off label" for children. A group of Polish infectious disease experts was created to develop evidence-based guidelines on the use of acyclovir in the treatment and prevention of varicella zoster and herpes simplex infections. In primary varicella zoster virus infections, oral acyclovir treatment is recommended in children over 12 years of age and should be considered in younger children who fall into one of the groups at risk of severe varicella. Intravenous acyclovir therapy in varicella is recommended in patients with immune deficiencies, newborns and in complicated cases. When there is a justified need for prevention of varicella, oral acyclovir prophylaxis may be considered if immunoglobulin cannot be administered, and if it is too late for vaccination. Oral acyclovir treatment of herpes zoster may be beneficial to otherwise healthy patients with a rash in places other than the trunk and in patients over 50 years of age. In immunocompetent patients with herpes simplex infections, indications for treatment with oral acyclovir include primary (genital herpes, skin herpes in children with atopic dermatitis, ocular herpes simplex, severe gingivostomatitis, paronychia and pharyngitis) and recurrent infections. Intravenous acyclovir should be administered for herpes infections in neonates, immunocompromised patients and patients who develop complications including neurological. PMID:26643900

  5. Effect of acyclovir on radiation- and chemotherapy-induced mouth lesions

    Several chemotherapeutic regimens and radiation therapy, if delivered to the oral mucosa, are associated with a high frequency of mouth lesions. The cause of this side effect is not known for certain, but in past studies it has sometimes been associated with the ability to culture herpes simplex virus type 1 from the mouth. In a double-blind prospective trial, patients with head and neck tumors treated with chemotherapy or radiation therapy were treated with either acyclovir or placebo. Although the frequency of culture-positive herpes simplex virus was low in the untreated group, it was significantly lower, zero, in the acyclovir-treated group. However, there were no differences in the frequency or type of mouth lesions experienced by patients receiving either radiation or chemotherapy who were taking acyclovir or placebo. These results suggest that herpes simplex virus is not a frequent cause or complication of oral lesions afflicting this patient population

  6. Enhancement of transdermal penetration and bioavailability of poorly soluble acyclovir using solid lipid nanoparticles incorporated in gel cream

    P S Gide

    2013-01-01

    Full Text Available The objective of this work was to increase the amount of acyclovir in the basal epidermis, site of herpes virus simplex infection, using the solid lipid nanoparticles loaded gel cream as carriers. Solid lipid nanoparticles were prepared by high pressure homogenisation method and incorporated in a semisolid submicron gel cream. Acyclovir distribution into rat skin after topical application of solid lipid nanoparticles loaded gel cream was determined by fabricated Franz diffusion cell. The results showed that, the quantity of the acyclovir in the basal epidermis with the solid lipid nanoparticles loaded submicron gel cream was two folds times more than marketed acyclovir gel cream. This type of carrier can improve acyclovir loaded therapy since it increases drug retention in the basal epidermis.

  7. Herpetic geometric glossitis: Acyclovir resistant case in a patient with acute myelogenous leukemia

    Pereira Claudio

    2010-01-01

    Full Text Available Herpes simplex virus (HSV infections in an immunocompromised host may be atypical in location and morphology. Lesions are more extensive and aggressive, slow healing or nonhealing and extremely painful. Intraoral lesions are ulcerative and may involve any intraoral, oropharyngeal, or esophageal site. Herpetic geometric glossitis is a recently described form of lingual HSV infection in an immunocompromised patient. It was described as ulcer on the dorsum of the tongue sensitive for acyclovir therapy. A patient is presented with acute myelogenous leukemia that developed herpetic geometric glossitis which was acyclovir resistant.

  8. Determination of Acyclovir in Human Plasma Samples by HPLC Method with UV Detection: Application to Single-Dose Pharmacokinetic Study

    Dragica Zendelovska

    2015-03-01

    CONCLUSION: Good precision, accuracy, simplicity, sensitivity and shorter time of analysis of the method makes it particularly useful for processing of multiple samples in a limited period of time for pharmacokinetic study of acyclovir.

  9. Acyclovir and hydrocortisone cream for the early treatment of recurrent cold sores

    Carrie A Sailer

    2011-01-01

    Full Text Available Carrie A Sailer1, Spotswood L Spruance2, Christopher M Hull11Department of Dermatology, 2Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, USAAbstract: Current antiviral therapies for herpes simplex labialis primarily reduce healing time. Since the host immune response also plays a role in both controlling recurrent infection as well as producing clinical symptoms, new studies are showing efficacy using topical corticosteroids. This review will evaluate the safety and efficacy of 5% acyclovir–1% hydrocortisone cream (Xerese™[US], Xerclear®[Europe] for treatment of patients with herpes simplex labialis. A large, randomized, double-blind, placebo-controlled study recently demonstrated that treatment with 5% acyclovir–1% hydrocortisone cream significantly decreased the percentage of ulcerative lesions, reduced lesion healing time, and decreased mean lesion area compared with both topical acyclovir alone and vehicle.Keywords: herpes labialis, herpes simplex virus, HSV, acyclovir, hydrocortisone, ME-609, Xerese, Xerclear

  10. Differential scanning calorimetry as a screening technique in compatibility studies of acyclovir extended release formulations

    Acyclovir (ACV) has been investigated during the past years, mainly due to its antiviral activity. Assessment of possible incompatibility between an active component and different excipients along with the evaluation of thermal stability are crucial parts of a normal study prior to the final formulation setting of a medicine. Thermal analysis studies were used as important and complementary tools during pre-formulation to determine the compatibility of drug excipients with the purpose of developing an acyclovir extended release formulation. Fourier transform infrared spectroscopy and X-ray powder diffraction analyses were also realized. The results showed that ACV only exhibited interaction which could influence the stability of the product in the binary mixtures of ACV/magnesium stearate. (author)

  11. A randomized, double-blind, comparative trial comparing high- and standard-dose oral acyclovir for first-episode genital herpes infections.

    Wald, A; Benedetti, J; Davis, G.; Remington, M; Winter, C; Corey, L

    1994-01-01

    Orally administered acyclovir ameliorates the clinical course and decreases the duration of viral shedding in patients with first-episode genital herpes infections. We investigated in a randomized, double-blind, comparative trial whether a higher (4 g) than standard (1 g) daily dose of oral acyclovir results in greater clinical benefit and influences the time to first recurrence. A total of 139 patients with first-episode genital herpes were randomized to receive orally 4 or 1 g of acyclovir ...

  12. Cellulose Acetate 398-10 Asymmetric Membrane Capsules for Osmotically Regulated Delivery of Acyclovir

    Alka Sonkar; Anil Kumar; Kamla Pathak

    2016-01-01

    The study was aimed at developing cellulose acetate asymmetric membrane capsules (AMCs) of acyclovir for its controlled delivery at the absorption site. The AMCs were prepared by phase inversion technique using wet process. A 23 full factorial design assessed the effect of independent variables (level(s) of polymer, pore former, and osmogen) on the cumulative drug release from AMCs. The buoyant optimized formulation F7 (low level of cellulose acetate; high levels of both glycerol and sodium l...

  13. [Treatment of mycosis fungoides with Zovirax (acyclovir). Study of 2 patients].

    Mahrle, G; Thiele, B; Steigleder, G K

    1985-04-01

    We report on two female patients suffering from mycosis fungoides, tumorous type but without systemic involvement, who have been treated with 400 mg Zovirax (Acyclovir) 3 times daily (about 15 mg/kg/day) for 12 days. The follow-up period amounted to 11 and 14 days, respectively. This therapy did not result in regression of the disease; one patient even showed progression of her skin tumors. PMID:4002770

  14. In vitro transcutaneous permeation of acyclovir sodium from HPMC gels: role of chemical permeation enhancers

    MATETI, ASHOK; Jukanti, Raju; Bandari, Suresh; Veerareddy, Prabhakar Reddy

    2010-01-01

    The main objective of the present study is to improve the permeation of acyclovir sodium (ACV) across stratum corneum (SC) from HPMC gel formulations. We have also investigated the role of chemical permeation enhancers like dimethyl sulfoxide, ethanol, limonene and sodium taurodeoxycholate on the transcutaneous permeation of ACV from HPMC gels. The optimized formulations were characterized and subjected to in vitro permeation study using excised rat abdominal skin. The histologica...

  15. Development of Clinical Resistance to Acyclovir in Herpes Simplex Virus-Infected Mice Receiving Oral Therapy

    Field, H J

    1982-01-01

    Mice inoculated in the ear pinna with herpes simplex virus were treated effectively by including 1 mg of acyclovir per ml in the drinking water. During a 5-day course of treatment the development of resistance was not readily apparent. However, when a suboptimal therapeutic dose was used and virus was repeatedly inoculated into further mice undergoing therapy, the infection became completely refractory to treatment by passage 4. Some of the viruses isolated exhibited reduced ability to induce...

  16. 阿昔洛韦杂质F的合成%Synthesis of Acyclovir Impurity F

    梁大伟

    2016-01-01

    In order to perform the quality control of acyclovir, the acyclovir impurity F was required as a chemical reference substance. Therefore, the impurity F was prepared by a highly regioselective O-deacetylation of acyclovir N,O-diacetate. The structure of the target compound was confirmed by 1H-NMR and MS, and the purity was over 99%by HPLC. The specified impurity could be used as the reference substance of the quality control in the development and manufacture of active pharmaceutical ingredient (API) and drug products.%以阿昔洛韦的合成中间体双乙酰阿昔洛韦为起始原料,经过一步区域选择性水解脱除O-乙酰基,得到阿昔洛韦杂质F。目标化合物的结构经过1H-NMR与MS确证,HPLC检测纯度达99%以上,可作为阿昔洛韦原料药质量控制的杂质对照品。

  17. Clinical efficacy of oral and topical acyclovir in herpes simplex virus stromal necrotizing keratitis

    Dutt, Surabhi; Acharya, Manisha; Gour, Abha; Sapra, Neelam; Chauhan, Lokesh; Mathur, Umang

    2016-01-01

    Purpose: To evaluate the efficacy of systemic and topical antiviral therapy in the treatment of active herpes simplex virus (HSV) necrotizing stromal keratitis (NSK). Design: Prospective interventional case series. Methodology: Patients with a diagnosis of HSV NSK based on history and clinical findings were enrolled in the study. A standard protocol was used for microbiologic investigations. Ten weeks regime of systemic acyclovir and 2 weeks of topical acyclovir was given. Complete ophthalmic examination was performed at every visit. Outcome measures were a reduction in the area of infiltration and improvement in visual acuity. Results: Fifteen patients were enrolled in the study. The mean age of presentation was 51.53 years. The duration of symptoms at presentation ranged from 2 to 8 weeks. HSV1 DNA polymerase chain reaction was positive in 70% cases of those tested. Area of infiltration at trial entry and at the end of 2 weeks of antiviral treatment reduced significantly (P = 0.007). All patients showed a complete resolution of keratitis at the end of study. Conclusion: Topical and systemic acyclovir for treatment of NSK facilitates healing of ulceration. Topical steroids after initial antiviral therapy are safe and decreases inflammation and improve visual recovery. Early initiation of therapy has better outcomes as compared to late presentations. PMID:27221681

  18. The Use Of Acyclovir And Phyllanthusniruri Supplement as Medication For Recurrent Intraoral Herpes Infections

    Marcia Marcia

    2012-12-01

    Full Text Available Recurrent intraoral herpes infection (RIH is one of the recurrent herpes simplex virus type-1 infections (HSV-1. It presents as single or clustered painful ulcers occur mainly on the keratinized mucosa, with the size of one to five millimeter. The Onset of RIH is considered to be associated with various endogenous and exogenous triggers. Therefore, it is important to recognize each individual triggers to prevent and to minimize and the infection for recurring. This report will describe three cases of RIH associated with emotional and physical stress. All patients have experienced continous recurrence of the disease for almost a year. Symptoms included painful multiple minute ulcers on oral mucosa initiated with fever. Serology investigation on antibody against HSV-1 confirmed a reactive elevation in these patients. Treatment consisted of acyclovir per oral 1000 mg daily per oral, counseling on stress condition and intake of nutritional supplementation. Nevertheless, stress conditions were difficult to overcome, therefore long-term medications were recommended to prevent recurrence episodes. One patient was taken a long-term acyclovir therapy and the other two patients were taken long-term acyclovir therapy with Phyllanthusniruri (Meniran supplementation. Follow-ups on three cases showed the benefit of taking Phyllanthusniruri (Meniran supplementation as reduction in RIH symptoms, shorten healing time and prolonged recurrence interval.DOI: 10.14693/jdi.v17i2.47

  19. The comparison between the efficacy of high dose acyclovir and erythromycin on the period and signs of pitiriasis rosea

    Ehsani Amirhooshang

    2010-01-01

    Full Text Available Background: Pityriasis Rosea (PR is an acute inflammatory and self-limiting skin disorder, sometimes with troublesome symptoms. To date, there are few treatments available for this disorder. Aim: Compare the traditional treatment with erythromycin to a newly introduced antiviral treatment acyclovir for PR. Materials and Methods: Patients with clinically confirmed diagnosis of PR, matching our exclusion criteria, were enrolled. They were randomized in two groups that received high-dose oral acyclovir or erythromycin. The participants were evaluated two, four, and eight weeks after commencement of the study and followed for one year. Results: A total of 30 patients including 15 males and 15 females completed the study. After eight weeks, 13 patients in the acyclovir group experienced complete response, while in the erythromycin group only six patients had complete response (P < 0.05. Also, patients in the acyclovir group experienced faster resolution of pruritus in comparison with the erythromycin group (not significant. No adverse drug reaction was detected in both groups. Conclusion: It seemed that a high-dose of oral acyclovir was a safe and effective therapy for PR, although this remained to be confirmed in larger studies.

  20. Acyclovir for treating varicella in otherwise healthy children and adolescents: a systematic review of randomised controlled trials

    Hartling Lisa

    2002-09-01

    Full Text Available Abstract Background Acyclovir has the potential to shorten the course of chickenpox which may result in reduced costs and morbidity. We conducted a systematic review of randomised controlled trials that evaluated acyclovir for the treatment of chickenpox in otherwise healthy children. Methods MEDLINE, EMBASE, and the Cochrane Library were searched. The reference lists of relevant articles were examined and primary authors and Glaxo Wellcome were contacted to identify additional trials. Two reviewers independently screened studies for inclusion, assessed study quality using the Jadad scale and allocation concealment, and extracted data. Continuous data were converted to a weighted mean difference (WMD. Overall estimates were not calculated due to differences in the age groups studied. Results Three studies were included. Methodological quality was 3 (n = 2 and 4 (n = 1 on the Jadad scale. Acyclovir was associated with a significant reduction in the number of days with fever, from -1.0 (95% CI -1.5,-0.5 to -1.3 (95% CI -2.0,-0.6. Results were inconsistent with respect to the number of days to no new lesions, the maximum number of lesions and relief of pruritis. There were no clinically important differences between acyclovir and placebo with respect to complications or adverse effects. Conclusion Acyclovir appears to be effective in reducing the number of days with fever among otherwise healthy children with chickenpox. The results were inconsistent with respect to the number of days to no new lesions, the maximum number of lesions and the relief of itchiness. The clinical importance of acyclovir treatment in otherwise healthy children remains controversial.

  1. Amino acid substitutions in the thymidine kinase gene of induced acyclovir-resistant herpes simplex virus type 1

    Hussin, Ainulkhir; Nor, Norefrina Shafinaz Md; Ibrahim, Nazlina

    2013-11-01

    Acyclovir (ACV) is an antiviral drug of choice in healthcare setting to treat infections caused by herpes viruses, including, but not limited to genital herpes, cold sores, shingles and chicken pox. Acyclovir resistance has emerged significantly due to extensive use and misuse of this antiviral in human, especially in immunocompromised patients. However, it remains unclear about the amino acid substitutions in thymidine (TK) gene, which specifically confer the resistance-associated mutation in herpes simplex virus. Hence, acyclovir-resistant HSV-1 was selected at high concentration (2.0 - 4.5 μg/mL), and the TK-gene was subjected to sequencing and genotypic characterization. Genotypic sequences comparison was done using HSV-1 17 (GenBank Accesion no. X14112) for resistance-associated mutation determination whereas HSV-1 KOS, HSV-1 473/08 and HSV clinical isolates sequences were used for polymorphism-associated mutation. The result showed that amino acid substitutions at the non-conserved region (UKM-1: Gln34Lys, UKM-2: Arg32Ser & UKM-5: Arg32Cys) and ATP-binding site (UKM-3: Tyr53End & UKM-4: Ile54Leu) of the TK-gene. These discoveries play an important role to extend another dimension to the evolution of acyclovir-resistant HSV-1 and suggest that selection at high ACV concentration induced ACV-resistant HSV-1 evolution. These findings also expand the knowledge on the type of mutations among acyclovir-resistant HSV-1. In conclusion, HSV-1 showed multiple strategies to exhibit acyclovir resistance, including amino acid substitutions in the TK gene.

  2. Evaluation of cross-linked chitosan microparticles containing acyclovir obtained by spray-drying

    The aim of this study was to obtain microparticles containing acyclovir (ACV) and chitosan cross-linked with tripolyphosphate using the spray-drying technique. The resultant system was evaluated through loading efficiency, differential scanning calorimetry (DSC), thermogravimetric analysis (TG), X-ray powder diffraction (XRPD), scanning electron microscopy (SEM), in vitro release and stability studies. The results obtained indicated that the polymer/ACV ratio influenced the final properties of the microparticles, with higher ratios giving the best encapsulation efficiency, dissolution profiles and stability. The DSC and XRPD analyses indicated that the ACV was transformed into amorphous form during the spray-drying process

  3. ACYCLOVIR IS ACTIVATED INTO A HIV-1 REVERSE TRANSCRIPTASE INHIBITOR IN HERPESVIRUS-INFECTED HUMAN TISSUES

    Lisco, Andrea; Vanpouille, Christophe; Tchesnokov, Egor P.; Grivel, Jean-Charles; Biancotto, Angélique; Brichacek, Beda; Elliott, Julie; Fromentin, Emilie; Shattock, Robin; Anton, Peter; Gorelick, Robert; Balzarini, Jan; McGuigan, Christopher; Derudas, Marco; Götte, Matthias

    2008-01-01

    For most viruses, there is a need for antimicrobials that target unique viral molecular properties. Acyclovir (ACV) is one such drug. It is activated into a human herpesvirus (HHV) DNA polymerase inhibitor exclusively by HHV kinases and, thus, does not suppress other viruses. Here, we show that ACV suppresses HIV-1 in HHV-coinfected human tissues, but not in HHV-free tissue or cell cultures. However, addition of HHV-6-infected cells renders these cultures sensitive to anti-HIV ACV activity. W...

  4. Reaction of cis- and trans-Dichlorotetra(Dimethylsulfoxide)Ruthenium(II) With the Antiviral Drug Acyclovir

    Koutsodimou, Aglaia; Natile, Giovanni

    2000-01-01

    NMR was used to investigate the reaction of cis- and trans-[RuCl2(DMSO)4] with the antiviral drug acyclovir, a guanine derivative containing the acyclic (2-hydroxo) ethoxymethyl pendant linked to N(9). Studies were performed in aqueous solutions at ambient temperature and at 37 °C, and at various molar ratios. Both isomers yielded two compounds, a monoadduct and a bisadduct, the relative yields being dependent upon the metal to ligand concentration ratios. The products derived from the two Ru...

  5. Development and Validation of Acyclovir HPLC External Standard Method in Human Plasma: Application to Pharmacokinetic Studies

    Selvadurai Muralidharan

    2014-01-01

    Full Text Available A simple, rapid, and selective RP-HPLC method was developed for the estimation of acyclovir in human plasma. The method involves a simple protein precipitation technique. Chromatographic separation was carried out on a reverse phase C18 column using mixture of 5 mM ammonium acetate (pH 4.0 and acetonitrile (40 : 60, v/v at a flow rate of 1.0 mL/min with UV detection at 290 nm. The retention time of acyclovir was 4.12 minutes. The method was validated and found to be linear in the range of 25.0–150.0 ng/mL. Validation studies were achieved by using the fundamental parameters, including accuracy, precision, selectivity, sensitivity, linearity and range, stability studies, limit of detection (LOD, and limit of quantitation (LOQ. It shows recovery at 91.0% which is more precise and accurate compared to the other method. These results indicated that the bioanalytical method was linear, precise, and accurate. The new bioanalytical method was successfully applied to a pharmacokinetic linearity study in human plasma.

  6. Cellulose Acetate 398-10 Asymmetric Membrane Capsules for Osmotically Regulated Delivery of Acyclovir

    Alka Sonkar

    2016-01-01

    Full Text Available The study was aimed at developing cellulose acetate asymmetric membrane capsules (AMCs of acyclovir for its controlled delivery at the absorption site. The AMCs were prepared by phase inversion technique using wet process. A 23 full factorial design assessed the effect of independent variables (level(s of polymer, pore former, and osmogen on the cumulative drug release from AMCs. The buoyant optimized formulation F7 (low level of cellulose acetate; high levels of both glycerol and sodium lauryl sulphate displayed maximum drug release of 97.88±0.77% in 8 h that was independent of variation in agitational intensity and intentional defect on the cellulose acetate AMC. The in vitro data best fitted zero-order kinetics (r2=0.9898. SEM micrograph of the transverse section confirmed the asymmetric nature of the cellulose acetate capsular membrane. Statistical analysis by Design Expert software indicated no interaction between the independent variables confirming the efficiency of the design in estimating the effects of variables on drug release. The optimized formulation F7 (desirability = 0.871 displayed sustenance of drug release over the drug packed in AMC in pure state proving the superiority of osmotically active formulation. Conclusively the AMCs have potential for controlled release of acyclovir at its absorption site.

  7. Indirect photochemical transformations of acyclovir and penciclovir in aquatic environments increase ecological risk.

    An, Jibin; Li, Guiying; An, Taicheng; Nie, Xiangping

    2016-03-01

    Acyclovir and penciclovir, 2 antiviral drugs, are increasingly detected in aquatic environments. The present study explores the natural photochemical transformation mechanisms and fate of these drugs, examining direct and indirect photochemical transformation under simulated sunlight irradiation. The 2 antiviral drugs are photostable under certain conditions but significantly degrade in the presence of chromophoric dissolved organic matter (DOM). The degradation rate associated with the drugs' indirect photochemical transformation scaled with chromophoric DOM concentration. Quenchers and sensitizers were used to identify indirect photochemical transformation mechanism. Results suggested that both pharmaceuticals could be transformed by reacting with (1) O2 , (•) OH, and excited chromophoric DOM. The (1) O2 played an important role in indirect photochemical transformation. Furthermore, the reaction kinetics between their substructural molecules, guanine, isocytosine, and imidazole, with different reactive oxygen species were evaluated to determine which substrate functionalities were most susceptible to singlet oxygenation. Imidazole was identified as the reaction site for (1) O2 , and preliminary (1) O2 oxidation mechanisms were further evaluated based on liquid chromatographic-tandem mass spectrometric results. Finally, aquatic ecotoxicity assessment of phototransformed solutions revealed that the degradation of acyclovir and penciclovir may not ultimately diminish environmental risk because of either formation of more toxic intermediates than parent pharmaceuticals or some synergistic effects existing between the intermediates. Environ Toxicol Chem 2016;35:584-592. © 2015 SETAC. PMID:26356329

  8. The Influence of Chitosan on the Oral Bioavailability of Acyclovir-a Comparative Bioavailability Study in Humans

    Kubbinga, M.; Nguyen, M.A.; Staubach, P.; Teerenstra, S.; Langguth, P.

    2015-01-01

    PURPOSE: The effects of chitosan hydrochloride on the oral absorption of acyclovir in humans were studied to confirm the absorption enhancing effects reported for in vitro and rat studies, respectively. METHODS: A controlled, open-label, randomized, 3-phase study was conducted in 12 healthy human vo

  9. Acyclovir Injection

    ... may be prescribed for other uses; ask your doctor or pharmacist for more information.This medication is most effective ... if they get worse.Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of ...

  10. A Case of Hailey-Hailey Disease That Responds Dramatically to Acyclovir Treatment

    İjlal Erturan

    2012-12-01

    Full Text Available Hailey-Hailey disease is an autosomal dominantly inherited chronic bullous dermatosis that tends to remain localized to flexural areas. The typical onset of the disease is through papulovesicles or flaccid bullae on an erythematous background. Lesions are often painful and itchy and sometimes cause a burning sensation. Although there is no effective treatment for the disease, topical and systemic corticosteroids and antibiotics are often used in the treatment. Hailey-Hailey disease creates a predisposition to infections due to the deterioration of skin barrier function. Underlying secondary infections should be investigated, particularly in cases with treatment failure. In this article we present a case of Hailey-Hailey disease who did not obtain benefits with conventional treatment modalities and was showing dramatic improvement due to treatment with acyclovir.

  11. Lack of effect of treatment with penciclovir or acyclovir on the establishment of latent HSV-1 in primary sensory neurons in culture.

    Smith, R L; Morroni, J; Wilcox, C L

    2001-10-01

    Recent studies suggest reductions in establishment of herpes simplex virus, type 1 (HSV-1) latency using the nucleoside analog penciclovir compared with acyclovir in the murine model. These observations raise the possibility that the new analogs may have novel activities that directly interfere with the establishment of the latent infection, suggesting a mechanism other than simply blocking the productive infection. To determine if penciclovir has a direct action on the establishment of latency, we compared the effects of penciclovir versus acyclovir in an in vitro model of HSV-1 latency in rat dorsal root ganglia neurons in culture. In neurons in culture, both penciclovir and acyclovir were highly effective in blocking the productive infection. However, neither penciclovir nor acyclovir blocked establishment of latency as demonstrated by similar percentages of neurons expressing the latency-associated transcript (LAT). Following removal of the respective nucleoside analog, latency was maintained until reactivation was induced by nerve growth factor deprivation. Similar virus titers were recovered after induction of reactivation of latent infections, which were established in the presence of either penciclovir or acyclovir. These results indicate that neither penciclovir nor acyclovir treatment directly prevents the establishment of latent HSV-1 infections in primary sensory neurons in culture. PMID:11530184

  12. Comparison of the Efficacy of Combination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy

    Ali KHAJEH

    2015-06-01

    Full Text Available How to Cite This Article: Khajeh A, Fayyazi A, Soleimani Gh, Miri-Aliabad Gh, Shaykh Veisi S, Khajeh B. Comparison of the Efficacy ofCombination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy. Iran J Child Neurol. Spring 2015; 9(2:17-20.AbstractObjectiveBell’s palsy is a rapid onset, usually, unilateral paralysis of the facial nerve that causes significant changes in an individual’s life such as a decline in personal, social, and educational performance. This study compared efficacy of combined prednisolone and acyclovir therapy with prednisolone alone.Materials & MethodsThis study is a randomized controlled trial conducted on 43 Children (2–18 years old with Bell’s palsy. The first group of 23 patients was treated with prednisolone and the remaining patients were treated with a combination of prednisolone and acyclovir. The required data were extracted, using an informational form based on the House-Brackmann Scale, which grades facial nerve paralysis. The data were analyzed with Mann-Whitney test using SPSS version 16.ResultsThe mean age of the first and second group were 8.65 ± 5.07 and 8.35 ± 4.92 years, respectively, (p=0.84. Sixty one percent and 39% of patients in the first group, and 45% and 55% of patients in the second group were male and female, respectively. No significant differences exist between the groups in terms of age and gender. The rate of complete recovery was 65.2% in group I and 90% in the group II (p=0.04.ConclusionThe results of this study showed that the combined prednisolone and acyclovir therapy of patients with Bell’s palsy is far more effective than treatment with prednisolone alone. Actually, age and gender had no impact on the rate of recovery.

  13. Chitosan and Kappa-Carrageenan Vaginal Acyclovir Formulations for Prevention of Genital Herpes. In Vitro and Ex Vivo Evaluation

    María-Pilar Sánchez-Sánchez

    2015-09-01

    Full Text Available Vaginal formulations for the prevention of sexually transmitted infections are currently gaining importance in drug development. Polysaccharides, such as chitosan and carrageenan, which have good binding capacity with mucosal tissues, are now included in vaginal delivery systems. Marine polymer-based vaginal mucoadhesive solid formulations have been developed for the controlled release of acyclovir, which may prevent the sexual transmission of the herpes simplex virus. Drug release studies were carried out in two media: simulated vaginal fluid and simulated vaginal fluid/simulated seminal fluid mixture. The bioadhesive capacity and permanence time of the bioadhesion, the prepared compacts, and compacted granules were determined ex vivo using bovine vaginal mucosa as substrate. Swelling processes were quantified to confirm the release data. Biocompatibility was evaluated through in vitro cellular toxicity assays, and the results showed that acyclovir and the rest of the materials had no cytotoxicity at the maximum concentration tested. The mixture of hydroxyl-propyl-methyl-cellulose with chitosan- or kappa-carrageenan-originated mucoadhesive systems that presented a complete and sustained release of acyclovir for a period of 8–9 days in both media. Swelling data revealed the formation of optimal mixed chitosan/hydroxyl-propyl-methyl-cellulose gels which could be appropriated for the prevention of sexual transmission of HSV.

  14. Chitosan and Kappa-Carrageenan Vaginal Acyclovir Formulations for Prevention of Genital Herpes. In Vitro and Ex Vivo Evaluation.

    Sánchez-Sánchez, María-Pilar; Martín-Illana, Araceli; Ruiz-Caro, Roberto; Bermejo, Paulina; Abad, María-José; Carro, Rubén; Bedoya, Luis-Miguel; Tamayo, Aitana; Rubio, Juan; Fernández-Ferreiro, Anxo; Otero-Espinar, Francisco; Veiga, María-Dolores

    2015-09-01

    Vaginal formulations for the prevention of sexually transmitted infections are currently gaining importance in drug development. Polysaccharides, such as chitosan and carrageenan, which have good binding capacity with mucosal tissues, are now included in vaginal delivery systems. Marine polymer-based vaginal mucoadhesive solid formulations have been developed for the controlled release of acyclovir, which may prevent the sexual transmission of the herpes simplex virus. Drug release studies were carried out in two media: simulated vaginal fluid and simulated vaginal fluid/simulated seminal fluid mixture. The bioadhesive capacity and permanence time of the bioadhesion, the prepared compacts, and compacted granules were determined ex vivo using bovine vaginal mucosa as substrate. Swelling processes were quantified to confirm the release data. Biocompatibility was evaluated through in vitro cellular toxicity assays, and the results showed that acyclovir and the rest of the materials had no cytotoxicity at the maximum concentration tested. The mixture of hydroxyl-propyl-methyl-cellulose with chitosan- or kappa-carrageenan-originated mucoadhesive systems that presented a complete and sustained release of acyclovir for a period of 8-9 days in both media. Swelling data revealed the formation of optimal mixed chitosan/hydroxyl-propyl-methyl-cellulose gels which could be appropriated for the prevention of sexual transmission of HSV. PMID:26393621

  15. Development of a multi-layered vaginal tablet containing dapivirine, levonorgestrel and acyclovir for use as a multipurpose prevention technology.

    McConville, Christopher; Major, Ian; Devlin, Brid; Brimer, Andrew

    2016-07-01

    Multipurpose prevention technologies (MPTs) are preferably single dosage forms designed to simultaneously address multiple sexual and reproductive health needs, such as unintended pregnancy, HIV infection and other sexually transmitted infections (STIs). This manuscript describes the development of a range of multi-layered vaginal tablets, with both immediate and sustained release layers capable of delivering the antiretroviral drug dapivirine, the contraceptive hormone levonorgestrel, and the anti-herpes simplex virus drug acyclovir at independent release rates from a single dosage form. Depending on the design of the tablet in relation to the type (immediate or sustained release) or number of layers, the dose of each drug could be individually controlled. For example one tablet design was able to provide immediate release of all three drugs, while another tablet design was able to provide immediate release of both acyclovir and levonorgestrel, while providing sustained release of Dapivirine for up to 8h. A third tablet design was able to provide immediate release of both acyclovir and levonorgestrel, a large initial burst of Dapivirine, followed by sustained release of Dapivirine for up to 8h. All of the tablets passed the test for friability with a percent friability of less than 1%. The hardness of all tablet designs was between 115 and 153N, while their drug content met the European Pharmacopeia 2.9.40 Uniformity of Dosage units acceptance value at levels 1 and 2. Finally, the accelerated stability of all three actives was significantly enhanced in comparison with a mixed drug control. PMID:27163243

  16. An open study of human lymphoblastoid interferon and oral acyclovir in chronic hepatitis B virus infection.

    Guarascio, P; De Felici, A P; Migliorini, D; Alexander, G J; Fagan, E A; Visco, G

    1986-01-01

    Ten patients were entered into an open study of interferon (IFN) 'induction' and oral acyclovir (ACV) 'maintenance' therapy. They received 5 Mega units (Mu)/m2 IFN by intramuscular injection daily for 3 days, followed by 7.5 Mu/m2 IFN daily for 7 days. IFN therapy was then discontinued and a 6-week course of oral ACV at a dose of 800 mg 4 times daily commenced. At 6 months, 2 patients had become HBeAg-negative and 1 had developed anti-HBe. Elimination of HBeAg in these patients was accompanied by return of serum liver function tests to normal. There was a statistically significant inhibition of DNA polymerase levels after the 1st week of IFN therapy, which then slowly increased to pretreatment values over 8 weeks. There were no significant adverse effects of ACV therapy, while fever, 'flu-like illness', fatigue, anorexia, and leucopenia were the main side-effects observed during the course of IFN which necessitated dose reduction in 7 patients. Combination therapy appears to effectively inhibit viral replication, although the 'maintenance' effect of oral ACV is minimal. A more effective drug to combine with IFN is needed. PMID:3598155

  17. Effect of Purine Nucleoside Analogue-Acyclovir on The Sperm Parameters and Testosterone Production in Rats

    Vahid Nejati

    2013-01-01

    Full Text Available Background: Acyclovir (ACV, a synthetic purine nucleoside analogue derived fromguanosine, is known to be toxic to gonads and the aim of this study was to evaluate theeffect of ACV on the sperm parameters and testosterone production in rat.Materials and Methods: In this experimental study, forty adult male Wistar rats (220± 20 g were randomly divided into five groups (n=8 for each group. One groupserved as control and one group served as sham control [distilled water was intraperitoneally(i.p. injected]. ACV was administered intraperitoneally in the drugtreatment groups (4, 16 and 48 mg/kg/day for 15 days. Eighteen days after the lastinjection, rats were sacrificed by CO2 inhalation. After that, cauda epididymideswere removed surgically. At the end, sperm concentrations in the cauda epididymis,sperm motility, morphology, viability, chromatin quality and DNA integrity wereanalyzed. Serum testosterone concentrations were determined.Results: The results showed that ACV did not affect sperm count, but decreased spermmotility and sperm viability at 16 and 48 mg/kg dose-levels. Sperm abnormalities increasedat 48 mg/kg dose-level of ACV. Further, ACV significantly increases DNA damageat 16 and 48 mg/kg dose-levels and chromatin abnormality at all doses. Besides, asignificant decrease in serum testosterone concentrations was observed at 16 and 48 mg/kg doses.Conclusion: The present results highly support the idea that ACV induces testicular toxicityby adverse effects on the sperm parameters and serum level of testosterone in malerats.

  18. Preparation and characterization of nanoparticles of carboxymethyl cellulose acetate butyrate containing acyclovir

    Vedula, Venkata Bharadwaz; Chopra, Maulick; Joseph, Emil; Mazumder, Sonal

    2016-02-01

    Nanoparticles of carboxymethyl cellulose acetate butyrate complexed with the poorly soluble antiviral drug acyclovir (ACV) were produced by precipitation process and the formulation process and properties of nanoparticles were investigated. Two different particle synthesis methods were explored—a conventional precipitation method and a rapid precipitation in a multi-inlet vortex mixer. The particles were processed by rotavap followed by freeze-drying. Particle diameters as measured by dynamic light scattering were dependent on the synthesis method used. The conventional precipitation method did not show desired particle size distribution, whereas particles prepared by the mixer showed well-defined particle size ~125-450 nm before and after freeze-drying, respectively, with narrow polydispersity indices. Fourier transform infrared spectroscopy showed chemical stability and intactness of entrapped drug in the nanoparticles. Differential scanning calorimetry showed that the drug was in amorphous state in the polymer matrix. ACV drug loading was around 10 wt%. The release studies showed increase in solution concentration of drug from the nanoparticles compared to the as-received crystalline drug.

  19. UV-SPECTROPHOTOMETRIC ESTIMATION OF ACYCLOVIR IN BULK AND PHARMACEUTICAL DOSAGE FORMS

    Narayana Raju Padala

    2013-08-01

    Full Text Available Analytical method development being a vital part of pre formulation-formulation research and development obviates the need to develop reliable, effective, eco friendly and cost effective methodologies for routine analysis of active pharmaceutical ingredients. UV spectroscopy is one of the earliest, yet of wide applications in drug analysis in different stages of formulations and quality control; despite the availabilities of sophisticated chromatographic techniques and other hyphenated techniques. Current research attempts to develop simple, sensitive, accurate, precise and economical UV spectrophotometric methods for the routine analysis of acyclovir in bulk and pharmaceutical dosage forms using two separate alkaline media, 0.1N NaOH (method A and 0.1N KOH (method B and validate them as per ICH guidelines. In both the methods maximum absorbance was observed at 264 nm. Beer’s law was obeyed in the concentration of 2.5-40 µg / mL in method A and 2.5-30 µg / mL in method B with correlation coefficient of 0.999. The % recovery carried out by adding known amount of standard drug to pre-analyzed tablet solutions was 98.75 ± 0.52 % to 99.78 ± 0.69 % (method A and 98.55 ± 0.31 % to 99.78 ± 0.22 % (method B. Intra and interday precision expressed in % RSD were 0.38 ± 0.01 and 0.27 ± 0.02 - 0.44 ± 0.01 respectively and the percent purity was 99.85 ± 0.05 %. The methods were validated statistically as per ICH guidelines and the results obtained were within the acceptance criteria for the parameters relating to linearity, accuracy, precision.

  20. Prevalence of Intrathecal Acyclovir Resistant Virus in Herpes Simplex Encephalitis Patients

    Mitterreiter, Johanna G.; Titulaer, Maarten J.; van Nierop, Gijsbert P.; van Kampen, Jeroen J. A.; Aron, Georgina I.; Osterhaus, Albert D. M. E.; Verjans, Georges M. G. M.; Ouwendijk, Werner J. D.

    2016-01-01

    Herpes simplex encephalitis (HSE) is a life-threatening complication of herpes simplex virus (HSV) infection. Acyclovir (ACV) is the antiviral treatment of choice, but may lead to emergence of ACV-resistant (ACVR) HSV due to mutations in the viral UL23 gene encoding for the ACV-targeted thymidine kinase (TK) protein. Here, we determined the prevalence of intrathecal ACVR–associated HSV TK mutations in HSE patients and compared TK genotypes of sequential HSV isolates in paired cerebrospinal fluid (CSF) and blister fluid of mucosal HSV lesions. Clinical samples were obtained from 12 HSE patients, encompassing 4 HSV type 1 (HSV-1) and 8 HSV-2 encephalitis patients. HSV DNA load was determined by real-time PCR and complete HSV TK gene sequences were obtained by nested PCR followed by Sanger sequencing. All HSV-1 HSE patients contained viral TK mutations encompassing 30 unique nucleotide and 13 distinct amino acid mutations. By contrast, a total of 5 unique nucleotide and 4 distinct amino acid changes were detected in 7 of 8 HSV-2 patients. Detected mutations were identified as natural polymorphisms located in non-conserved HSV TK gene regions. ACV therapy did not induce the emergence of ACVR-associated HSV TK mutations in consecutive CSF and mucocutaneous samples of 5 individual patients. Phenotypic susceptibility analysis of these mucocutaneous HSV isolates demonstrated ACV-sensitive virus in 2 HSV-1 HSE patients, whereas in two HSV-2 HSE patients ACVR virus was detected in the absence of known ACVR-associated TK mutations. In conclusion, we did not detect intrathecal ACVR-associated TK mutations in HSV isolates obtained from 12 HSE patients. PMID:27171421

  1. Electrosprayed core–shell solid dispersions of acyclovir fabricated using an epoxy- coated concentric spray head

    Liu ZP

    2014-04-01

    Full Text Available Zhe-Peng Liu,1 Lei Cui,2 Deng-Guang Yu,3 Zhuan-Xia Zhao,1 Lan Chen11School of Medical Instrument and Food Engineering, 2Tin Ka Ping College of Science, 3School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, People's Republic of ChinaAbstract: A novel structural solid dispersion (SD taking the form of core–shell microparticles for poorly water-soluble drugs is reported for the first time. Using polyvinylpyrrolidone (PVP as a hydrophilic polymer matrix, the SDs were fabricated using coaxial electrospraying (characterized by an epoxy-coated concentric spray head, although the core fluids were unprocessable using one-fluid electrospraying. Through manipulating the flow rates of the core drug-loaded solutions, two types of core–shell microparticles with tunable drug contents were prepared. They had average diameters of 1.36±0.67 and 1.74±0.58 µm, and were essentially a combination of nanocomposites with the active ingredient acyclovir (ACY distributed in the inner core, and the sweeter sucralose and transmembrane enhancer sodium dodecyl sulfate localized in the outer shell. Differential scanning calorimetry and X-ray diffraction results demonstrated that ACY, sodium dodecyl sulfate, and sucralose were well distributed in the PVP matrix in an amorphous state because of favorable second-order interactions. In vitro dissolution and permeation studies showed that the core–shell microparticle SDs rapidly freed ACY within 1 minute and promoted nearly eightfold increases in permeation rate across the sublingual mucosa compared with raw ACY powders.Keywords: core–shell microparticle, solid dispersion, coaxial electrospraying, poorly water-soluble drug, epoxy-coated spray head

  2. Acyclovir Therapy Reduces the CD4+ T Cell Response against the Immunodominant pp65 Protein from Cytomegalovirus in Immune Competent Individuals.

    Annette Pachnio

    Full Text Available Cytomegalovirus (CMV infects the majority of the global population and leads to the development of a strong virus-specific immune response. The CMV-specific CD4+ and CD8+ T cell immune response can comprise between 10 and 50% of the T cell pool within peripheral blood and there is concern that this may impair immunity to other pathogens. Elderly individuals with the highest magnitude of CMV-specific immune response have been demonstrated to be at increased risk of mortality and there is increasing interest in interventions that may serve to moderate this. Acyclovir is an anti-viral drug with activity against a range of herpes viruses and is used as long term treatment to suppress reactivation of herpes simplex virus. We studied the immune response to CMV in patients who were taking acyclovir to assess if therapy could be used to suppress the CMV-specific immune response. The T cell reactivity against the immunodominant late viral protein pp65 was reduced by 53% in people who were taking acyclovir. This effect was seen within one year of therapy and was observed primarily within the CD4+ response. Acyclovir treatment only modestly influenced the immune response to the IE-1 target protein. These data show that low dose acyclovir treatment has the potential to modulate components of the T cell response to CMV antigen proteins and indicate that anti-viral drugs should be further investigated as a means to reduce the magnitude of CMV-specific immune response and potentially improve overall immune function.

  3. Absence of rapid selection for acyclovir or penciclovir resistance following suboptimal oral prodrug therapy of HSV-infected mice

    Bacon Teresa H

    2001-12-01

    Full Text Available Abstract Background Acyclovir (ACV resistant herpes simplex virus (HSV isolates can be readily selected in animal infection models receiving suboptimal ACV treatment, however no comparative studies of the emergence of resistance following suboptimal treatment with valacyclovir (VCV or famciclovir (FCV, the prodrugs of acyclovir and penciclovir, respectively, have been reported. Methods Mice (n = 30 were infected with HSV type 1 or 2 in the ear pinnae and administered oral prodrugs at one fifth a dose previously shown to be effective. To select and amplify drug-resistant HSV, a total of seven consecutive in vivo passages with suboptimal treatment were performed for each virus sample and progeny virus from each passage was characterized by the plaque reduction (PRA and plating efficiency assays (PEA. Results No drug-resistant HSV-2 and only a single drug-resistant HSV-1 variant were identified. Virus recovered from the first three sequential passages of this HSV-1 sample was susceptible by PRA, although the proportion of resistant virus recovered gradually increased upon passage. The resistant HSV-1 phenotype was confirmed by PRA after four sequential passages in mice. Unexpectedly, this in vivo-selected drug-resistant HSV-1 failed to yield an infection completely refractory to treatment in subsequent passages. Conclusions Sub-optimal therapy of immunocompetent mice with either VCV or FCV did not readily select for HSV-mutants resistant to either ACV or PCV, suggesting that selection of resistance with either prodrug remains difficult using this system. Futhermore, this study suggests that the PEA may represent a useful adjunct to the PRA for monitoring alterations in the proportion of drug-resistant virus even when no change in IC50 is apparent.

  4. A comparative study of lamellar gel phase systems and emzaloids as transdermal drug delivery systems for acyclovir and methotrexate / Sonique Reynecke

    Reynecke, Sonique

    2004-01-01

    The skin forms an attractive and accessible route for systemic delivery of drugs as alternative to other methods of administration, such as the oral and parental methods because of the problems associated with last mentioned methods. The lipophilic character of the stratum corneum, coupled with its intrinsic tortuosity, ensures that it almost always provides the principal barrier to the entry of drug molecules into the skin. Due to the fact that methotrexate (MTX) and acyclovir...

  5. 口服阿昔洛韦治疗水痘的疗效评价%The curative effect of oral acyclovir in treatment of chickenpox

    邓建军; 黄国珍; 朱渝; 喻韬; 万朝敏

    2012-01-01

    OBJECTIVE To evaluate the efficacy of oral acyclovir in treatment of chickenpox. METHODS Updated evidences were identified by searching Cochrane library, MEDUNE and EMBASE. Only systematic reviews, randomized controlled trials (RCTs) and quasi- RCTs were included. The efficacy of oral acyclovir in treatment of chickenpox in healthy children was analyzed through evidence-based methods. RESULTS Oral acyclovir was associated with the reductions in the number of days with fever and in the number of rash. There were less supportive evidences in shortening the number of days to get new rash and relieving pruritus. CONCLUSION The clinical importance of oral acyclovir treatment in healthy children remains uncertain.%目的 对口服阿昔洛韦治疗水痘的疗效进行循证评价.方法 使用相关检索词对Cochrane图书馆、MEDLINE及EMBASE等数据库进行检索,获得关于口服阿昔洛韦治疗水痘的疗效的系统评价及随机对照实验,用循证医学的方法对口服阿昔洛韦治疗水痘的疗效进行评价.结果 口服阿昔洛韦能减少患者发热的天数及水痘皮疹的数量,但在缩短新生皮损出现时间及减轻皮肤瘙痒等方面尚不明确.结论 阿昔洛韦在治疗平素健康儿童水痘患者的重要性仍不明确.

  6. Utilization of nanotechnology to enhance percutaneous absorption of acyclovir in the treatment of herpes simplex viral infections

    Al-Subaie MM

    2015-06-01

    Full Text Available Mutlaq M Al-Subaie,1 Khaled M Hosny,1,2 Khalid Mohamed El-Say,1,3 Tarek A Ahmed,1,3 Bader M Aljaeid1 1Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 2Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni Suef University, Beni Suef, 3Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt Abstract: This study aimed to formulate an optimized acyclovir (ACV nanoemulsion hydrogel in order to provide a solution for the slow, variable, and incomplete oral drug absorption in patient suffering from herpes simplex viral infection. Solubility of ACV in different oils, surfactants, and cosurfactants was explored utilizing a cubic model mixture design to obtain a nanoemulsion with minimum globule size. Preparation of an optimized ACV nanoemulsion hydrogel using a three-factor, three-level Box–Behnken statistical design was conducted. The molecular weight of chitosan (X1, percentage of chitosan (X2, and percentage of Eugenol as a skin permeation enhancer (X3 were selected to study their effects on hydrogel spreadability (Y1 and percent ACV permeated through rat skin after 2.5 hours (Y2. A pharmacokinetic study of the optimized ACV nanoemulsion hydrogel was conducted in rats. Mixtures of clove oil and castor oil (3:1 ratio, Tween 80 and Span 80 (3:1 ratio, and propylene glycol and Myo-6V (3:1 ratio were selected as the oil, surfactant, and cosurfactant phases, respectively. Statistical analysis indicated that the molecular weight of chitosan has a significant antagonistic effect on spreadability, but has no significant effect on the percent ACV permeated. The percentage of chitosan also has a significant antagonistic effect on the spreadability and percent ACV permeated. On the other hand, the percentage of Eugenol has a significant synergistic effect on percent ACV permeated, with no effect on

  7. Conformational Analysis, Molecular Structure and Solid State Simulation of the Antiviral Drug Acyclovir (Zovirax) Using Density Functional Theory Methods

    Alvarez-Ros, Margarita Clara; Palafox, Mauricio Alcolea

    2014-01-01

    The five tautomers of the drug acyclovir (ACV) were determined and optimised at the MP2 and B3LYP quantum chemical levels of theory. The stability of the tautomers was correlated with different parameters. On the most stable tautomer N1 was carried out a comprehensive conformational analysis, and the whole conformational parameters (R, β, Φ, φ1, φ2, φ3, φ4, φ5) were studied as well as the NBO Natural atomic charges. The calculations were carried out with full relaxation of all geometrical parameters. The search located at least 78 stable structures within 8.5 kcal/mol electronic energy range of the global minimum, and classified in two groups according to the positive or negative value of the torsional angle φ1. In the nitrogen atoms and in the O2' and O5' oxygen atoms of the most stable conformer appear a higher reactivity than in the natural nucleoside deoxyguanosine. The solid state was simulated through a dimer and tetramer forms and the structural parameters were compared with the X-ray crystal data available. Several general conclusions were emphasized. PMID:24915059

  8. Conformational Analysis, Molecular Structure and Solid State Simulation of the Antiviral Drug Acyclovir (Zovirax Using Density Functional Theory Methods

    Margarita Clara Alvarez-Ros

    2014-06-01

    Full Text Available The five tautomers of the drug acyclovir (ACV were determined and optimised at the MP2 and B3LYP quantum chemical levels of theory. The stability of the tautomers was correlated with different parameters. On the most stable tautomer N1 was carried out a comprehensive conformational analysis, and the whole conformational parameters (R, β, Φ, φ1, φ2, φ3, φ4, φ5 were studied as well as the NBO Natural atomic charges. The calculations were carried out with full relaxation of all geometrical parameters. The search located at least 78 stable structures within 8.5 kcal/mol electronic energy range of the global minimum, and classified in two groups according to the positive or negative value of the torsional angle j1. In the nitrogen atoms and in the O2' and O5' oxygen atoms of the most stable conformer appear a higher reactivity than in the natural nucleoside deoxyguanosine. The solid state was simulated through a dimer and tetramer forms and the structural parameters were compared with the X-ray crystal data available. Several general conclusions were emphasized.

  9. Evaluation of the in vitro skin permeation of antiviral drugs from penciclovir 1% cream and acyclovir 5% cream used to treat herpes simplex virus infection

    Bader Marlene

    2009-04-01

    Full Text Available Abstract Background Herpes simplex virus infection (HSV is a common and ubiquitous infection of the skin which causes mucocutaneous lesions called cold sores (herpes labialis or fever blisters. It is estimated that approximately 80% of the population worldwide are carriers of the Herpes simplex virus, approximately 40% suffer from recurrent recurrent infections. This study evaluates the in vitro skin permeation and penetration of penciclovir and acyclovir from commercialized creams for the treatment of herpes labialis (cold sores, using non viable excised human abdominal skin samples, which were exposed to 5 mg/cm2 of acyclovir 5% cream or penciclovir 1% cream. Methods After 24 h of cream application, excess cream was washed off and layers of stratum corneum were removed by successive tape stripping. Amounts of active ingredients having penetrated through the skin were measured, as well as the amounts in the washed-off cream, in skin strips and creams remaining in the skin. Molecular modelling was used to evaluate physico-chemical differences between the drugs. Western blot analysis enabled to determine whether the marker of basal cells keratin 5 could be detected in the various tape strips. Results Application of penciclovir 1% cream yielded higher concentration of drug in the deeper layers of the epidermis as well as a higher drug flux through the skin. Molecular modelling showed two higher hydrophobic moieties for acyclovir. Presence of the basal cell marker keratin 5 was underscored in the deeper tape strips from the skin, giving evidence that both drugs can reach their target cells. Conclusion Penciclovir 1% cream has the tendency to facilitate the diffusion of the drug through the stratum corneum into the deeper epidermis layers, in which it could reach the target basal cells at effective therapeutical concentration. The small difference in the surface properties between both molecules might also contribute to favour the passage of

  10. Full clinical recovery after topical acyclovir treatment of Epstein-Barr virus associated cutaneous B-cell lymphoma in patient with mycosis fungoides.

    Copur, M Sitki; Deshpande, Anita; Mleczko, Kris; Norvell, Max; Hrnicek, Gordon J; Woodward, Suzette; Frankforter, Scott; Mandolfo, Natalie; Fu, Kai; Chan, Wing C

    2005-06-01

    Primary cutaneous T- and B-cell lymphomas are a heterogeneous group of diseases with varied clinical presentations and prognosis. The use of new molecular, histological, and clinical criteria has improved their recognition. Cutaneous B-cell and T-cell lymphomas are seldom found together in the same patient. Here we report a rare case of mycosis fungoides variant of a cutaneous T-cell lymphoma (CTCL) which later developed Epstein-Barr virus (EBV) associated cutaneous B-cell lymphoproliferative disorder. The patient initially presented with generalized erythroderma, extensive plaques, and axillary lymphadenopathy. Histopathology and immunophenotyping of her tumor from the right breast nodule revealed a T-cell lymphoma consistent with mycosis fungoides. She was initially treated with pentostatin, followed by topical mechlorethamine and topical steroids. After progression of her mycosis fungoides with worsening diffuse skin lesions on this regimen, her treatments were changed to oral bexarotene with an initial partial response followed by stable disease. Three years from her initial presentation, she developed ulcerated cauliflower-like nodules on her forehead. Biopsy of these lesions revealed EBV-positive large- and medium-sized pleomorphic B-cells consistent with EBV-driven B-cell lymphoproliferative disorder. She was treated with topical acyclovir cream on the involved skin areas while continuing with oral bexarotene for mycosis fungoides. Skin lesions gradually diminished and totally disappeared after four weeks of topical acyclovir treatment. Bexarotene treatment was continued for another year until the mycosis fungoides progressed and became wide spread causing her death four and a half years after the initial diagnosis. The coexistence of two cutaneous non-Hodgkin lymphomas of different lineage in the same patient and the complete clinical response of EBV-related B-cell cutaneous component to topical acyclovir makes this rare case particularly interesting. PMID

  11. Utilization of nanotechnology to enhance percutaneous absorption of acyclovir in the treatment of herpes simplex viral infections.

    Al-Subaie, Mutlaq M; Hosny, Khaled M; El-Say, Khalid Mohamed; Ahmed, Tarek A; Aljaeid, Bader M

    2015-01-01

    This study aimed to formulate an optimized acyclovir (ACV) nanoemulsion hydrogel in order to provide a solution for the slow, variable, and incomplete oral drug absorption in patient suffering from herpes simplex viral infection. Solubility of ACV in different oils, surfactants, and cosurfactants was explored utilizing a cubic model mixture design to obtain a nanoemulsion with minimum globule size. Preparation of an optimized ACV nanoemulsion hydrogel using a three-factor, three-level Box-Behnken statistical design was conducted. The molecular weight of chitosan (X1), percentage of chitosan (X2), and percentage of Eugenol as a skin permeation enhancer (X3) were selected to study their effects on hydrogel spreadability (Y1) and percent ACV permeated through rat skin after 2.5 hours (Y2). A pharmacokinetic study of the optimized ACV nanoemulsion hydrogel was conducted in rats. Mixtures of clove oil and castor oil (3:1 ratio), Tween 80 and Span 80 (3:1 ratio), and propylene glycol and Myo-6V (3:1 ratio) were selected as the oil, surfactant, and cosurfactant phases, respectively. Statistical analysis indicated that the molecular weight of chitosan has a significant antagonistic effect on spreadability, but has no significant effect on the percent ACV permeated. The percentage of chitosan also has a significant antagonistic effect on the spreadability and percent ACV permeated. On the other hand, the percentage of Eugenol has a significant synergistic effect on percent ACV permeated, with no effect on spreadability. The ex vivo study demonstrated that the optimized ACV nanoemulsion hydrogel showed a twofold and 1.5-fold higher permeation percentage than the control gel and marketed cream, respectively. The relative bioavailability of the optimized ACV nanoemulsion hydrogel improved to 535.2% and 244.6% with respect to the raw ACV hydrogel and marketed cream, respectively, confirming improvement of the relative bioavailability of ACV in the formulated nanoemulsion

  12. 阿昔洛韦与更昔洛韦治疗成人水痘的疗效比较%Comparison of Therapeutic Efficacy of Acyclovir and Ganciciovir in the Treatment of Adult Chickenpox

    陈孝虹; 林敏

    2011-01-01

    OBJECTIVE: To compare the therapeutic efficacy of acyclovir vs. Ganciclovir in the treatment of adult chickenpox. METHODS: 140 patients with chickenpox in our hospital were randomly divided into acyclovir group and ganciclovir group, according to odd and even days of hospitalization. They were given acyclovir and ganciclovir 10 mg·kg-1, bid, iv.gtt. The average defervescence time, the time for herpes forming a scab, total effective rate and adverse drug reaction were observed in 2 groups. RESULTS: The defervescence time of ganciclovir group was significantly shorter in acyclovir group, the difference was statistically significant (P 0.05); Total effective rte of ganciclovir group was significantly higher than that of acyclovir group, the difference was statistically significant (p<0.05). No adverse drug reaction was found in 2 groups during the treatment. CONCLUSIONS: The therapeutic efficacy of ganciclovir in the treatment of adult varicella is significantly better than acyclovir, and the defervescence time of ganciclovir is shorter than acyclovir.%目的:比较阿昔洛韦与更昔洛韦治疗成人水痘的疗效.方法:将我院140例水痘患者,按住院单双日随机均分为阿昔洛韦组与更昔洛韦组,分别给予阿昔洛韦与更昔洛韦10 mg·kg-1,bid,静脉滴注.观察并记录2组患者的退热时间、皮疹结痂时间、总有效率和不良反应.结果:更昔洛韦组患者的退热时间明显短于阿昔洛韦组,2组比较差异有统计学意义(P<0.05);2组的皮疹结痂时间比较,差异无统计学意义(P>0.05);更昔洛韦组的总有效率明显高于阿昔洛韦组(P<0.05).2组治疗过程中,均未见不良反应发生.结论:更昔洛韦治疗成人水痘的疗效显著优于阿昔洛韦,且退热时间短于阿昔洛韦.

  13. Modification of glassy carbon electrode with a bilayer of multiwalled carbon nanotube/tiron-doped polypyrrole: Application to sensitive voltammetric determination of acyclovir

    A novel voltammetric sensor based on glassy carbon electrode (GCE) modified with a thin film of multi-walled carbon nanotubes (MWCNTs) coated with an electropolymerized layer of tiron-doped polypyrrole was developed and the resulting electrode was applied for the determination of acyclovir (ACV). The surface morphology and property of the modified electrode were characterized by field emission scanning electron microscopy and electrochemical impedance spectroscopy techniques. The electrochemical performance of the modified electrode was investigated by means of linear sweep voltammetry (LSV). The effect of several experimental variables, such as pH of the supporting electrolyte, drop size of the cast MWCNTssuspension, number of electropolymerization cycles and accumulation time was optimized by monitoring the LSV response of the modified electrode toward ACV. The best response was observed at pH 7.0 after accumulation at open circuit for 160 s. Under the optimized conditions, a significant electrochemical improvement was observed toward the electrooxidation of ACV on the modified electrode surface relative to the bare GCE, resulting in a wide linear dynamic range (0.03–10.0 μM) and a low detection limit (10.0 nM) for ACV. Besides high sensitivity, the sensor represented high stability and good reproducibility for ACV analysis, and provided satisfactory results for the determination of this compound in pharmaceutical and clinical preparations. - Highlights: • A simple method was employed to construct a thin film modified electrode. • Tiron-doped polypyrrole was electropolymerized on MWCNT precast glassy carbon electrode. • Electrode surface characterization was performed by microscopic and spectroscopic techniques. • The modified electrode showed nano-molar detection limit for acyclovir. • The modified electrode was applied for the detection of ACV in pharmaceutical and clinical preparations

  14. Modification of glassy carbon electrode with a bilayer of multiwalled carbon nanotube/tiron-doped polypyrrole: Application to sensitive voltammetric determination of acyclovir

    Shahrokhian, Saeed, E-mail: shahrokhian@sharif.edu [Department of Chemistry, Sharif University of Technology, Tehran 11155-3516 (Iran, Islamic Republic of); Institute for Nanoscience and Technology, Sharif University of Technology, Tehran (Iran, Islamic Republic of); Azimzadeh, Mahnaz [Department of Chemistry, Sharif University of Technology, Tehran 11155-3516 (Iran, Islamic Republic of); Amini, Mohammad K. [Department of Chemistry, Isfahan University, Isfahan (Iran, Islamic Republic of)

    2015-08-01

    A novel voltammetric sensor based on glassy carbon electrode (GCE) modified with a thin film of multi-walled carbon nanotubes (MWCNTs) coated with an electropolymerized layer of tiron-doped polypyrrole was developed and the resulting electrode was applied for the determination of acyclovir (ACV). The surface morphology and property of the modified electrode were characterized by field emission scanning electron microscopy and electrochemical impedance spectroscopy techniques. The electrochemical performance of the modified electrode was investigated by means of linear sweep voltammetry (LSV). The effect of several experimental variables, such as pH of the supporting electrolyte, drop size of the cast MWCNTssuspension, number of electropolymerization cycles and accumulation time was optimized by monitoring the LSV response of the modified electrode toward ACV. The best response was observed at pH 7.0 after accumulation at open circuit for 160 s. Under the optimized conditions, a significant electrochemical improvement was observed toward the electrooxidation of ACV on the modified electrode surface relative to the bare GCE, resulting in a wide linear dynamic range (0.03–10.0 μM) and a low detection limit (10.0 nM) for ACV. Besides high sensitivity, the sensor represented high stability and good reproducibility for ACV analysis, and provided satisfactory results for the determination of this compound in pharmaceutical and clinical preparations. - Highlights: • A simple method was employed to construct a thin film modified electrode. • Tiron-doped polypyrrole was electropolymerized on MWCNT precast glassy carbon electrode. • Electrode surface characterization was performed by microscopic and spectroscopic techniques. • The modified electrode showed nano-molar detection limit for acyclovir. • The modified electrode was applied for the detection of ACV in pharmaceutical and clinical preparations.

  15. Study on the Formula of Self-emulsifying Drug Delivery System for Acyclovir%阿昔洛韦自乳化释药系统的处方研究

    叶蕾; 徐诗梦; 胡卢丰; 张秀华

    2012-01-01

    目的:研究阿昔洛韦自乳化释药系统的处方.方法:通过阿昔洛韦在介质中的溶解度试验,处方配伍,三元图绘制和粒径考察,以介质溶解度,溶液澄清度,是否有淡蓝色乳光,自微乳化时间和粒径大小为指标,筛选油相、乳化剂和助乳化剂之间的最佳配伍和比例.结果:阿昔洛韦自乳化释药系统的最佳处方为肉豆蔻酸异丙酯(IPM)、聚氧乙烯蓖麻油(Cremophor EL)和甘油,配伍比为0.25:0.375:0.375,该系统自乳化能力强,性质稳定.结论:初步成功地制备了阿昔洛韦自乳化释药系统制剂,有效改善了阿昔洛韦的溶解度.%Objective: To study the formula of acyclovir-loaded self-emulsifying drug delivery system ( SEDDS ). Method: The optimal compatibility and ratio of the oil phase, the emulsifier and the co-emulsifier were screened using solubility experiment, formula compatibility, the ternary phase diagram and size observation with the acyclovir solubility in the solvents, clarity, light blue opalescent, self-emulsifying time and particle size as the indices. Result: The optimal formula consisted of IPM, Cremophor EL and glycerin( 0. 25 :0. 375=0. 375 ) . The optimal SEDDS was promising in self-emulsification and stability. Conclusion: Acyclovir-loaded self-emulsifying preparation is prepared successfully, which can improve the solubility and bioavailability in vivo.

  16. Protocol for German trial of Acyclovir and corticosteroids in Herpes-simplex-virus-encephalitis (GACHE: a multicenter, multinational, randomized, double-blind, placebo-controlled German, Austrian and Dutch trial [ISRCTN45122933

    Schielke Eva

    2008-10-01

    Full Text Available Abstract Background The treatment of Herpes-simplex-virus-encephalitis (HSVE remains a major unsolved problem in Neurology. Current gold standard for therapy is acyclovir, a drug that inhibits viral replication. Despite antiviral treatment, mortality remains up to 15%, less than 20% of patients are able to go back to work, and the majority of patients suffer from severe disability. This is a discouraging, unsatisfactory situation for treating physicians, the disabled patients and their families, and constitutes an enormous burden to the public health services. The information obtained from experimental animal research and from recent retrospective clinical observations, indicates that a substantial benefit in outcome can be expected in patients with HSVE who are treated with adjuvant dexamethasone. But currently there is no available evidence to support the routine use of adjuvant corticosteroid treatment in HSVE. A randomized multicenter trial is the only useful instrument to address this question. Design GACHE is a multicenter, randomized, double-blind, placebo-controlled, parallel group clinical trial of treatment with acyclovir and adjuvant dexamethasone, as compared with acyclovir and placebo in adults with HSVE. The statistical design will be that of a 3-stage-group sequential trial with potential sample size adaptation in the last stage. Conclusion 372 patients with proven HSVE (positive HSV-DNA-PCR, aged 18 up to 85 years; with focal neurological signs no longer than 5 days prior to admission, and who give informed consent will be recruited from Departments of Neurology of academic medical centers in Germany, Austria and The Netherlands. Sample size will potentially be extended after the second interim analysis up to a maximum of 450 patients. Trial Registration Current Controlled Trials ISRCTN45122933

  17. Intravenous drip acyclovir hematuria in 1 case analysis%静脉滴注阿昔洛韦致血尿1例分析

    蒋庆锋; 吴建军

    2015-01-01

    阿昔洛韦是第三代广谱抗病毒药物,为合成的嘌呤核苷类似物,用于治疗单纯疱疹病毒感染和带状疱疹病毒感染,由英国葛兰素-威尔康研发并于1981年5月在英国首次上市,目前已被世界上包括美国在内的50多个国家批准上市使用,是世界上销售量最大的抗病毒药物之一,具有高效、低毒、广谱、对病毒选择性高的特点。临床用于单纯疱疹病毒感染的治疗与预防,带状疱疹以及免疫缺陷者水痘的治疗。%Acyclovir is the third generation of broad-spectrum antiviral drugs, for the synthesis of purine nucleoside analogues, used in the treatment of herpes simplex virus infection, and herpes zoster virus infection by the British glaxo - will, research and development and in May 1981 for the first time in the UK, has been the world more than 50 countries, including the United States, approved to use, is one of the largest antiviral drug sales in the world, and has high efficiency, low toxicity and the characteristics of broad spectrum, high selectivity to the virus. Clinical used in the treatment of herpes simplex virus infection and prevention, the treatment of herpes zoster and immunodeficiency chickenpox.

  18. Clinical observation the effects of combination application of salvia miltiorrhiza and acyclovir (ACV) on acute retinal necrosis (ARN)%丹参、无环鸟苷联合治疗急性视网膜坏死

    蒋美峰; 方春庭

    2000-01-01

    目的:为了探讨急性视网膜坏死(acute retinal necrosis,ARN)的有效疗法.方法:对6例(8只眼)ARN患者采用丹参、无环鸟苷(acyclovir,ACV)联合治疗.结果:随访6~18个月,7只眼视力有不同程度提高,视力提高达88.8%.结论:丹参、ACV联合应用是治疗ARN的一种有效方法.

  19. Efficacy of Early Treatment of Bell’s Plasy With Prednisone and Acyclovir%早期泼尼松联合阿昔洛韦治疗 Bell 麻痹的疗效观察

    陶涛; 杨军; 秦新月; 李倩

    2015-01-01

    目的:比较单用泼尼松与泼尼松联合阿昔洛韦治疗急性期 Bell 麻痹的疗效。方法164例发病时间在72h以内的 Bell 麻痹患者。其中,单纯泼尼松治疗组79例,泼尼松联合阿昔洛韦治疗组85例。以 House -Brackmann 分级法作为治疗后3个月面神经功能的评估标准。结果治疗3个月后,泼尼松联合阿昔洛韦治疗组面瘫完全恢复率为87.1%,略高于单用泼尼松组的84.8%(=0.024,P >0.05)。入院时严重瘫痪的患者,联合治疗组面瘫完全恢复率为85.5%,单用泼尼松治疗完全恢复率为81.8%,两组间比较差异无统计学意义(=0.313,P >0.05)。结论早期泼尼松联合阿昔洛韦治疗 Bell 麻痹疗效并不优于单用泼尼松治疗组。%Objective To compare the therapeutic efficacy of prednisolone alone to acyclovir plus prednisolone in patients with acute idiopathic facial palsy. Methods Using a prospective design. A total of 164 patients suffering from Bell’s plasy within 72 hours after the onset of symptoms were divided into prednisolone group(n = 79)and prednisolone plus acyclovir group(n = 85).The demographic data and clinical characteristics in both groups were collected. Facial nerve function outcomes were evaluated 3 months after the onset with House-Brackmann grading system. Results The proportions of patients who had completely recovered at 3 months in prednisolone plus acyclovir group were slightly higher than that in the prednisolone group(87. 1% vs 84. 8% , =0. 024, P > 0. 05). Patients with severe plasy, the recovery rate that treated with prednisolone plus acyclovir and prednisolone a-lone were 85. 5% and 81. 8% , respectively. There was no significant difference( = 0. 313, P > 0. 05). Conculsion Patients with Bell’s palsy, early treatment with prednisolone in combination with acyclovir is no better than the single treatment with pred-nisolone.

  20. Radiosensitization of human glioma cells in vitro and in vivo with acyclovir and mutant HSV-TK75 expressed from adenovirus

    Purpose: We recently reported that an adenovirus-expressing mutant HSV-TK75 (AdCMV-TK75) radiosensitized rat syngeneic gliomas in combination with low concentrations of acyclovir (ACV) much more effectively than a virus expressing wild-type herpes simplex virus thymidine kinase (HSV-TK). In this report we have examined whether similar radiosensitizing effects are also seen with human glioma cells in vitro and in vivo. Methods and Materials: Human U87 MG glioma cells were transduced with AdCMV-TK75 and exposed to ACV followed by single-dose irradiation and colony-forming survival assays. Similarly, U87 MG xenografts were infused with AdCMV-TK75 or Adβgal control virus, followed by ACV administration and fractionated irradiation. Therapeutic efficacy was monitored by tumor growth. Results: U87 MG cells transduced with AdCMV-TK75 were significantly more sensitive to ACV (3 μM) than cells transduced with either wild-type HSV-TK or control virus. To determine whether human cells also demonstrate improved radiosensitization similar to that seen with rat glioma cells and tumors, we transduced U87 MG cells with either AdCMV-TK75, AdCMV-TK, expressing wild-type HSV-TK, or Adβgal and then treated the cells with 3 μM of ACV. Cells transduced with AdCMV-TK75 were significantly more radiosensitive (dose enhancement ratio [D37]: 2.6) by colony-forming survival assay than cells transduced with either AdCMV-TK or Adβgal. Furthermore, we found that U87 MG xenografts infused with AdCMV-TK75 by slow positive pressure infusion were more radiosensitive after administration of ACV than tumors infused with Adβgal. A more dramatic result was achieved when fractionated irradiation was carried out concurrently with ACV administration, in which case AdCMV-TK75-treated tumors did not grow at all. Conclusions: These results demonstrate that transduction of human glioma cells in vitro and infusion of xenografts in vivo with AdCMV-TK75 and treatment with concentrations of ACV that can be

  1. 高压氧联合阿昔洛韦治疗Bell麻痹效果观察%Observation of Curative Effect in Treatment of Bell Palsy with Hyperbaric Oxygen and Acyclovir

    周平; 郭光汉; 刘顺饶; 王耀辉; 李想

    2012-01-01

    目的 探讨高压氧联合阿昔洛韦治疗Bell麻痹的效果.方法 我院2008年12月~2010年12月收治Bell麻痹71例,随机分为治疗组和对照组.治疗组37例予高压氧治疗每日1次;对照组34例施以针灸治疗,每日1次.两组均予呋喃硫胺20mg和维生素B120.5mg肌内注射每日1次,阿昔洛韦6~10 mg/(kg·d)静脉滴注每日1次,地塞米松3~5 mg/(kg·d)静脉滴注每日1次,疗程10 d.结果 治疗组治愈率51.35%,总有效率100%;对照组治愈率29.41%,总有效率94.12%.两组治愈率比较差异有统计学意义(P<0.05).结论 高压氧联合阿昔洛韦治疗Bell麻痹安全有效,可作为Bell麻痹治疗首选方案.%Objective To explore the curative effect in treatment of Bell palsy with hyperbaric oxygen and acyclovir. Methods 71 patients with Bell palsy in our hospital during Dec. 2008 and Dec. 2010 were randomized into treatment group and control group. The treatment group received Hyperbaric oxygen therapy qd. The control group received acupuncture therapy qd. Both groups were given 20 mg of Fursultiamine, 0.5 mg im of Vitamin B12, qd, 6-10 mg/(kg·d), iv, Acyclovir, qd, and 3-5mg/ (kg·d), iv, Dexamethasone qd. The course of treatment was 10 d. Results The curative ratio and total effective rate of treatment group were 51.35% , 100% . In control group, the curative ratio was 29.41 % and total effective rate was 94.12% . There was significant difference in curative ratio between the two groups (P<0.05). Conclusion Hyperbaric oxygen and Acyclovir approach is safe and effective in the treatment of Bell palsy, and is preferred in curing Bells palsy.

  2. Desenvolvimento e validação de um método analítico simples e rápido por espectroscopia UV para quantificação de aciclovir em matrizes hidrofílicas de liberação prolongada Development and validation of a simple and rapid analytical method by UV spectroscopy for acyclovir quantification in hydrophilic matrices for sustained release

    Fernanda Malaquias Barboza

    2010-01-01

    Full Text Available This work reports the validation of an analytical UV spectrophotometric method to assay acyclovir in hydrophilic matrices (assay and dissolution studies. The method was linear in the range between 2.5-20 µg mL-1, presenting a good correlation coefficient ( r = 0,9999. Precision and accuracy analysis showed low relative standart deviation (< 2.0 % and a good recoveries percentual (98.9-100 %. The procedure was linear, accurate, and robust. The method is simple and cheap. It does not use polluting reagents and can be applied in dissolution studies, being an adequate alternative to assay acyclovir in hydrophilic matrices tablets.

  3. The Effects of Combination of Traditional Chinese Medicine, Acyclovir (ACV) and Corticosteroid on Acute Retinal Necrosis (ARN)%中药、无环鸟苷、皮质激素联合治疗急性视网膜坏死

    陈卫玲; 杨志坤; 滕颖; 马晓萍

    2001-01-01

    目的:为了探讨急性视网膜坏死(acute retinal necrosis,ARN)的有效疗法.方法:对8例(11只眼)ARN患者用中药、无环鸟苷(acyclovir,ACV)、激素联合治疗.结果:随访3~36个月,10只眼视力有不同程度提高,视力提高达90.9%结论:中药、ACV、激素联合应用是治疗ARN的一种有效方法.

  4. Study on the Optimal Concentration of Honey to Enhance the Effect of Acyclovir on Herpes Simplex Virus Keratitis Model Rabbits%蜂蜜增强阿昔洛韦对单纯疱疹病毒性角膜炎模型兔药效的最佳浓度实验研究

    何群; 王适; 张湘晖; 伍参荣; 姜宇; 赵碧清

    2011-01-01

    目的:探索蜂蜜增强阿昔洛韦(ACV)对单纯疱疹病毒性角膜炎(HSK)模型兔药效的最佳浓度,为2药联用提供依据.方法:对兔角膜采用上皮划痕法接种单纯疱疹病毒Ⅰ型病毒株建立HSK模型,将模型兔随机分为7组,每组4只(8只眼),分别为:Ⅰ~Ⅳ组(蜂蜜与3%ACV混合凝胶,其中蜂蜜含量分别为0、3%、5%、7%)、V组(只建模)、Ⅵ组(3%ACV眼膏)、Ⅶ组(空白基质),每日涂相应眼药3次,每次给药0.1g,间隔4h,连续给药12d.用裂隙灯观察各组给药第3、6、9、12天(次日给药前观察)情况并进行药效评分,再对药效评分进行等级一致性检验,找出药效最优组别.结果:每组各时间段药效评分结果不同,但从综合药效评分排序可知:Ⅲ组>Ⅳ组>Ⅱ组>Ⅵ组>Ⅰ组≈Ⅶ组≈V组,等级有一致性的倾向,以含5%蜂蜜与3%ACV混合凝胶药效最强,优于其他组.结论:蜂蜜增强3%ACV对HSK药效的最佳浓度为5%.%OBJECTIVE: To explore the optimal concentration of honey to enhance the effect of acyclovir (ACV) on the rabbits with herpes simplex virus keratitis (HSK) , and to provide reference for drug combination. METHODS: Rabbit cornea were vaccinated against type I herpes simplex strain by epithelium scratch method to establish HSK model. Model rabbits were randomly divided into 7 groups with 4 rabbits (8 eyes) in each group: I.e. Groups I ~IV (gel of honey mixed with 3% ACV, containing 0, 3% , 5% , 7% honey); group V (model established only); group VI (3% acyclovir eye ointment); groups W (blank matrix). They were given relevant medicine 3 times a day, 0.1 g each time every 4 hour for 12 days. Slitlampmicroscope was used to observe therapeutic efficacy on 3rd, 6th, 9th, 12th day (before administration the next day). Level consistency test of therapeutic efficacy was conducted to find out optimal therapeutic efficacy. RESULTS: The pesticide effects of each group were different at different time in

  5. Electrosprayed core–shell solid dispersions of acyclovir fabricated using an epoxy- coated concentric spray head

    Liu ZP; Cui L.; Yu DG; Zhao ZX; Chen L

    2014-01-01

    Zhe-Peng Liu,1 Lei Cui,2 Deng-Guang Yu,3 Zhuan-Xia Zhao,1 Lan Chen11School of Medical Instrument and Food Engineering, 2Tin Ka Ping College of Science, 3School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, People's Republic of ChinaAbstract: A novel structural solid dispersion (SD) taking the form of core–shell microparticles for poorly water-soluble drugs is reported for the first time. Using polyvinylpyrrolidone (PVP) as a hydro...

  6. Topical delivery of different ketoconazole and acyclovir formulations / Danélia Botes

    Botes, Danélia

    2012-01-01

    Acquired immunodeficiency syndrome (AIDS) has shown a rapid increase in incidence over the past 25 years. Many clinical manifestations occur in patients infected with human immunodeficiency virus (HIV) due to compromised immunity caused by this virus. Dermatological disorders are almost inevitable for individuals suffering from HIV/AIDS and are seen in approximately 90% of all infected patients (Cedeno-Laurent et al., 2011:5; Dlova & Mosam, 2004:12). Vulnerability of the skin causes impaired ...

  7. A Case of Hailey-Hailey Disease That Responds Dramatically to Acyclovir Treatment

    İjlal Erturan; Ali Murat Ceyhan; Gonca Meriç; Vahide Baysal Akkaya

    2012-01-01

    Hailey-Hailey disease is an autosomal dominantly inherited chronic bullous dermatosis that tends to remain localized to flexural areas. The typical onset of the disease is through papulovesicles or flaccid bullae on an erythematous background. Lesions are often painful and itchy and sometimes cause a burning sensation. Although there is no effective treatment for the disease, topical and systemic corticosteroids and antibiotics are often used in the treatment. Hailey-Hailey disease creates a ...

  8. Electrosprayed core–shell solid dispersions of acyclovir fabricated using an epoxy- coated concentric spray head

    Yu, Deng-Guang

    2014-01-01

    Zhe-Peng Liu,1 Lei Cui,2 Deng-Guang Yu,3 Zhuan-Xia Zhao,1 Lan Chen11School of Medical Instrument and Food Engineering, 2Tin Ka Ping College of Science, 3School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, People's Republic of ChinaAbstract: A novel structural solid dispersion (SD) taking the form of core–shell microparticles for poorly water-soluble drugs is reported for the first time. Using polyvinylpyrrolidone (PVP) as...

  9. Randomized clinical study comparing Compeed (R) cold sore patch to acyclovir cream 5% in the treatment of herpes simplex labialis

    Karlsmark, T.; Goodman, J.J.; Drouault, Y.;

    2008-01-01

    Background Hydrocolloid technology has been proven effective in treating dermal wounds. A previous study showed that a newly developed thin hydrocolloid patch [Compeed (R) cold sore patch (CSP)] provided multiple wound-healing benefits across all stages of a herpes simplex labialis (HSL) outbreak...... onset of symptoms until the lesion healed, for a maximum of 10 days. The primary end point was the subject's global assessment of therapy (SGAT; 0-10 scale; 0 = no response, 10 = excellent response). Multiple secondary end points included clinician-assessed healing time and subject assessment of lesion...

  10. Effects of herpes simplex virus thymidine kinase/acyclovir system on growth of human pulmonary adenocarcinoma A549 cell line in vitro and in vivo

    HE Xiang-liang; HE Dong-hua; GUO Xian-jian; QIAN Gui-sheng; HUANG Gui-jun; CHEN Wei-zhong; LI Shu-ping

    2002-01-01

    Objective: To observe the effect of anciclovir (ACV) treatment on tumors induced by inoculation of TK gene-transfected human pulmonary adenocarcinoma A549 cells in nude mice. Methods: A recombinant plasmid containing TK gene was constructed and transfected into A549 cells by electroporation. The sensitivity of the transgenic cells (A549-TK) to ACV was examined by MTT assay in vitro and for in vivo observation, inoculation of A549-TK and A-549 cells into nude mice was separately performed to induce tumor growth, the response of which to ACV treatment was observed, and the tumor tissues were pathologically examined. Results: A recombinant plasmid containing TK gene was successfully constructed and transfected into A549 cells. The sensitivity of A549-TK cells to ACV was 43 times higher than that of A549 cells. The tumors induced by A549-TK cells showed no significant increase in size after ACV treatment (P>0. 05), and light microscopy revealed local tissue necrosis, karyoklasis, and nuclei disappearance. Conclusion: A549-TK cells acquires sensitivity to ACV both in vitro and in vivo, and ACV can inhibit the growth of tumors induced by A549-TK cell inoculation in nude mice.

  11. 复方樟柳碱联合无环鸟苷治疗急性视网膜坏死%Clinical effects of combination application of compound anisodin and acyclovir(ACV)on acute retinal necrosis(ARN)

    王涌; 邱颖杰

    2010-01-01

    目的 探讨急性视网膜坏死(ARN)的有效治疗方法.方法 将20例22眼随机分为治疗组和常规组两组,治疗组12眼采用复方樟柳碱联合无环鸟苷(ACV)治疗,与常规组10眼进行对比现察.结果 经3~15个月的观察随访,治疗组12眼中有10眼视力不同程度提高,提高率为83%.结论 复方樟柳碱联合无环鸟苷是治疗ARN的一种有效方法.

  12. 无环鸟苷、丹参联合治疗急性视网膜坏死的研究%Study of combination of acyclovir and salvia miltiorrhiza on acute retinal necrosis

    王圣祥; 丁波

    2004-01-01

    目的探讨急性视网膜坏死(ARN)的治疗方法.方法对8例(10眼)ARN患者采用无环鸟苷、丹参联合治疗.结果随访12~18个月,9眼视力有不同程度提高,视力提高率达90%.结论无环鸟苷、丹参联合治疗ARN是一种有效的方法.

  13. An Observation of Clinical Efficacy of Acyclovir in 24 Cases of Child Chickenpox%阿昔洛韦治疗小儿水痘24例疗效观察

    江月萍; 顾仁月

    2010-01-01

    目的:探讨阿昔洛韦对小儿水痘的临床疗效及安全性.方法:46例水痘患儿随机分为两组,治疗组24例用阿昔洛韦5 mg/(kg·次),每日4次口服,对照组22例用利巴韦林注射液10 mg/(kg·d),每日静脉滴注一次,疗程均为5 d,其他治疗方法相同.结果:治疗组热退及结痂时间较对照组缩短(P0.05).结论:阿昔洛韦对小儿水痘有显著疗效,而且安全可靠.

  14. Clinical study on the treating of Thymosin and acyclovir treatment of children with chickenpox%胸腺肽联合阿昔洛韦治疗小儿水痘临床观察

    段树鹏

    2009-01-01

    目的:胸腺肽、阿昔洛韦治疗小儿水痘98例疗效观察.方法:采用随机对照治疗,将水痘患儿分为胸腺肽联合阿昔洛韦治疗组50例,胸腺肽10~20mg/d,静脉滴注,阿昔洛韦10~15mg/kg,分2次静脉注射,连用7d;对照组48例,阿昔洛韦10~15mg/kg,分2次静脉注射,连用7d.结果:治疗组总有效率为94.0%;对照组总有效率为72.9%.结论:胸腺肽联合阿昔洛韦治疗小儿水痘有很好疗效.

  15. 盐酸伐昔洛韦与阿昔洛韦治疗儿童水痘疗效的临床观察%Clinical Observation of Valaciclovir Hydrochioride and Acyclovir in the Treatment of Children with Chickenpox

    林菁; 朱炜春; 谭丽丽; 胡丹

    2015-01-01

    目的 对比分析盐酸伐昔洛韦和阿昔洛韦治疗儿童水痘的临床疗效.方法 选取我院2013年9月至2014年11月期间因水痘需住院治疗惠儿90例,随机分为2组,每组45例,分别予以盐酸伐昔洛韦(观察组)和阿昔洛韦(对照组)进行治疗,比较两组治疗后临床疗效、疗效指数和不良反应情况.结果 观察组治愈率80.0%高于对照组53.3%,总有效率97.8%高于对照组84.4%,疗效指数(0.86±0.31)高于对照组(0.53±0.29),差异均具有统计学意义(均P<0.05);观察组瘙痒消失时间(0.7±0.2)d、全部结痂时间(2.3±0.5)d、痂落自愈时间(5.4±1.0)d均短于对照组,差异均具有统计学意义(均P <0.05);观察组总不良反应率与对照组比较,差异无统计学意义(P>0.05).结论 盐酸伐昔洛韦治疗儿童水痘临床效果较好,疗效指数更高,症状体征消失快,且不良反应无异常增高,适合临床应用推广.

  16. Effective observation of 50 children with chicken pox treatedby by orally acyclovir%口服联合外用阿昔洛韦治疗小儿水痘50例临床疗效观察

    范慧海; 陈萌新; 何梅玲

    2007-01-01

    目的 观察口服阿昔洛韦基础上加用3%阿昔洛韦软膏外用治疗小儿水痘的疗效.方法 将100例水痘患儿随机分为2组,治疗组50例用阿昔洛韦口服加3%阿昔洛韦软膏外用和对照组50例口服阿昔洛韦,分析其疗效.结果 治疗组与对照组比较,前者在有效率(P<0.01)、治愈率、退热时间和疱疹结痂时间(P<0.05)等均优于后者.结论 口服阿昔洛韦加3%阿昔洛韦软膏外用疗效优于口服阿昔洛韦,值得临床推广.

  17. Drug: D00222 [KEGG MEDICUS

    Full Text Available D00222 Drug Aciclovir (JP16/INN); Acyclovir (USP); Sitavig (TN); Zovirax (TN) C8H11...Ophthalmic agents 1319 Others D00222 Aciclovir (JP16/INN); Acyclovir (USP) 6 Agents against pathologic organ...isms and parasites 62 Chemotherapeutics 625 Antivirals 6250 Antivirals D00222 Aciclov...SE D06BB Antivirals D06BB03 Aciclovir D00222 Aciclovir (JP16/INN); Acyclovir (USP...eosides and nucleotides excl. reverse transcriptase inhibitors J05AB01 Aciclovir D00222 Aciclovir (JP16/INN)

  18. Herpes simplex encephalitis: MRI findings in two cases confirmed by polymerase chain reaction assay

    Herpes simplex virus (HSV) type I causes a fulminant necrotising meningoencephalitis distinguished from other encephalitides by its focal and often haemorrhagic nature. Specific antiviral therapy with acyclovir can significantly improve the prognosis. We present MRI findings of two cases of herpes simplex encephalitis (HSE) confirmed by PCR analysis, focusing on the serial changes after acyclovir therapy: gyral swelling, high signal intensity on T2-weighted images in the subfrontal region, temporal lobe and insula in the initial stage, then regional extension with enhancement and haemorrhage despite appropriate acyclovir therapy, and finally encephalomalacia and brain atrophy. (orig.)

  19. Main structural and stereochemical aspects of the antiherpetic activity of nonahydroxyterphenoyl-containing C-glycosidic ellagitannins.

    Quideau, Stéphane; Varadinova, Tatiana; Karagiozova, Diana; Jourdes, Michael; Pardon, Patrick; Baudry, Christian; Genova, Petia; Diakov, Theodore; Petrova, Rozalina

    2004-02-01

    Antiherpetic evaluation of five nonahydroxyterphenoyl-containing C-glycosidic ellagitannins, castalagin (1), vescalagin (2), grandinin (3), roburin B (5), and roburin D (7), was performed in cultured cells against four HSV-1 and HSV-2 strains, two of which were resistant to Acyclovir. All five ellagitannins displayed significant anti-HSV activities against the Acyclovir-resistant mutants, but the monomeric structures 1-3 were more active than the dimers 5 and 7. Vescalagin (2) stands out among the five congeners tested as the most potent and selective inhibitor, with an IC50 value in the subfemtomolar range and a selectivity index 5x10(5) times higher than that of Acyclovir. Molecular modeling was used to provide a rationale for the surprisingly lower activity profile of its epimer castalagin (1). These ellagitannins have promising potential as novel inhibitors in the search for non-nucleoside drugs active against Acyclovir-resistant herpes viruses. PMID:17191843

  20. Acute pancreatitis : complication of chicken pox in an immunocompetent host.

    Roy, Pinaki; Maity, Pranab; Basu, Arindam; Dey, Somitra; Das, Biman; Ghosh, U S

    2012-12-01

    Chicken pox is a benign self limited disease. But it may rarely be complicated with acute pancreatitis in otherwise healthy patient. We present a case of varicella pancreatitis and its marked recovery with acyclovir. PMID:23781673

  1. Skin delivery of selected hydrophilic drugs used in the treatment of skin diseases associated with HIV/AIDS by using elastic liposomes / Kevin Bassey Ita

    Ita, Kevin Bassey

    2003-01-01

    Due to the immuncompromised status of AIDS patients, secondary infections and malignancies are common. Conditions secondary to AIDS for which patients require treatment include Karposi's sarcoma (treated with methotrexate), varicella-zoster (treated with antivirals such as acyclovir) and herpes simplex (also treated with antivirals like acyclovir or idoxuridme). However the clinical efficacy of these drugs is limited by poor skin permeability. Few reports, however, have deal...

  2. A Study of the Antiviral Effect of the Essential oil of Zataria Multiflora Boiss on Herpes Simplex Type 1 in Vero Cell Culture

    Mardani M; Motamedifar M.; Hoseinipour R.

    2012-01-01

    Statement of Problems: Herpes Simplex type 1 (HSV-1) is associated with different human infections including oral infection. Acyclovir is used for the treatment of such herpetic infections. However, acyclovir resistant HSVs are increasing nowadays due to the lack of thymidine kinase activity in HSV mutants. So, researchon alternative treatment is urgently required. Purpose: The aim of this study was to examine the effect of essential oil of Zataria multiflora Boiss on herpes simplex type 1 in...

  3. Drug: D02764 [KEGG MEDICUS

    Full Text Available OTHERAPEUTICS FOR DERMATOLOGICAL USE D06B CHEMOTHERAPEUTICS FOR TOPICAL USE D06BB Antivirals D06BB03 Aciclov...NTIINFECTIVES S01AD Antivirals S01AD03 Aciclovir D02764 Acyclovir sodium (USAN) USP drug classification [BR:...Antiinfectives [BR:br08307] Antivirals Anti-HSV agent DNA polymerase inhibitor Purine analogue Aciclovir [AT...se inhibitors J05AB01 Aciclovir D02764 Acyclovir sodium (USAN) S SENSORY ORGANS S01 OPHTHALMOLOGICALS S01A A...ECT ACTING ANTIVIRALS J05AB Nucleosides and nucleotides excl. reverse transcripta

  4. Prodrugs of purine and pyrimidine analogues for the intestinal di/tri-peptide transporter PepT1

    Thomsen, Anne Engelbrecht; Friedrichsen, Gerda Marie; Sørensen, Arne Hagsten; Andersen, Rikke; Nielsen, Carsten Uhd; Brodin, Birger; Begtrup, Mikael; Frokjaer, Sven; Steffansen, Bente

    A general drug delivery approach for increasing oral bioavailability of purine and pyrimidine analogues such as acyclovir may be to link these compounds reversibly to stabilized dipeptide pro-moieties with affinity for the human intestinal di/tri-peptide transporter, hPepT1. In the present study......, novel L-Glu-Sar and D-Glu-Ala ester prodrugs of acyclovir and 1-(2-hydroxyethyl)-linked thymine were synthesized and their affinities for hPepT1 in Caco-2 cells were determined. Furthermore, the degradation of the prodrugs was investigated in various aqueous and biological media and compared to the...

  5. Polyneuritis cranialis following herpes zoster

    Radhakrishna H; Malakondaiah T; Reddy I; Saheb D

    2000-01-01

    Herpes zoster is a common clinical condition involving cranial nerves. We encountered 3 cases in which multiple cranial nerves were involved besides the commoner ones. All the three cases were treated with acyclovir and oral steroids. Recovery of motor function was only partial in all three cases when reviewed 2 months after discharge. The clinical details and a brief review of literature are presented.

  6. Eldercare at Home: Skin Problems

    ... can ease the symptoms. Doctors often prescribe an anti-viral drug, such as acyclovir (ZoviraxTM), valacyclovir (ValtrexTM), ... dealing with common caregiving problems. © 2016 Health in Aging. All rights reserved. Feedback • Site Map • Privacy Policy • ...

  7. Ionic liquid-assisted transdermal delivery of sparingly soluble drugs.

    Moniruzzaman, Muhammad; Tahara, Yoshiro; Tamura, Miki; Kamiya, Noriho; Goto, Masahiro

    2010-03-01

    We report the first successful application of a novel IL-assisted non-aqueous microemulsion stabilized by a blend of two nontoxic surfactants, polyoxyethylene sorbitan monooleate (Tween-80), and sorbitan laurate (Span-20) for transdermal delivery of acyclovir, which is insoluble or sparingly soluble in water and most common organic liquids. PMID:20162145

  8. Toxic effects of bis(thiosemicarbazone) compounds and its palladium(II) complexes on herpes simplex virus growth

    Here, we present data on the activity of benzyl bis(thiosemicarbazone); 3,5-diacyl-1,2,4-triazole bis(4-methylthiosemicarbazone) and their Pd(II) complexes against the replication of wild type and of acyclovir (ACV)-resistant, herpes simplex virus type 1 (HSV 1) and type 2 (HSV 2) strains. The data were compared to those under the action of acyclovir. The testing of cytotoxic activity suggests that these compounds may be endowed with important antiviral properties. It is interesting to note that the Pd(II)-benzyl bis(thiosemicarbazone) complex, 2, exhibits a significant activity against acyclovir-resistant viruses R-100 (HSV 1) and PU (HSV 2) with an in vitro selectivity index (SI) of 8.0 vs. 0.01 for acyclovir. This complex also negatively influenced the expression of key structural HSV 1 proteins (VP23, gH and gG/gD), thus suppressing simultaneously virus entry, transactivation of virus genome, capsid assembly, and cell-to-cell spread of infectious HSV progeny

  9. Varicella-zoster virus transverse myelitis in an immunocompetent patient

    Jemshad Alungal; Mansoor C. Abdulla; Jassim Mohamad Koya; Krishnan R

    2014-01-01

    Transverse myelitis is one of the rare neurological complications of Varicella-Zoster Virus (VZV) infection in immuno-competent. We report a 26-year-old immuno-competent gentleman who developed virologically confirmed myelopathy caused by VZV which improved with steroids and acyclovir leaving no residual neurological deficits. [Int J Res Med Sci 2014; 2(3.000): 1154-1156

  10. Toxic effects of bis(thiosemicarbazone) compounds and its palladium(II) complexes on herpes simplex virus growth.

    Genova, Petia; Varadinova, Tatiana; Matesanz, Ana I; Marinova, Desislava; Souza, Pilar

    2004-06-01

    Here, we present data on the activity of benzyl bis(thiosemicarbazone); 3,5-diacyl-1,2,4-triazole bis(4-methylthiosemicarbazone) and their Pd(II) complexes against the replication of wild type and of acyclovir (ACV)-resistant, herpes simplex virus type 1 (HSV 1) and type 2 (HSV 2) strains. The data were compared to those under the action of acyclovir. The testing of cytotoxic activity suggests that these compounds may be endowed with important antiviral properties. It is interesting to note that the Pd(II)-benzyl bis(thiosemicarbazone) complex, 2, exhibits a significant activity against acyclovir-resistant viruses R-100 (HSV 1) and PU (HSV 2) with an in vitro selectivity index (SI) of 8.0 vs. 0.01 for acyclovir. This complex also negatively influenced the expression of key structural HSV 1 proteins (VP23, gH and gG/gD), thus suppressing simultaneously virus entry, transactivation of virus genome, capsid assembly, and cell-to-cell spread of infectious HSV progeny. PMID:15163546

  11. Post varicella zoster virus myelitis in immunocompetent patients.

    Ben-Amor, Sana; Lammouchi, Turkia; Benslamia, Lamia; Benammou, Soufiene

    2011-04-01

    We report 2 immunocompetent patients with myelitis. The first was a 55-year old man who developed myelitis after intercostal herpes zoster. The second was a 19-year-old boy who presented with myelopathy after varicella infection. Varicella-zoster virus (VZV) myelitis was diagnosed based on the close temporal relationship between rash and onset of clinical symptoms, and by the elevated rate of anti-VZV IgG in the CSF without oligoclonal bands in the first case, and presence of VZV DNA in the second. The course was favorable after a 3-day course of corticosteroids and 3 weeks of acyclovir. Varicella-zoster virus myelitis is uncommon; it affects essentially immunodepressed patients. We highlight the importance of considering the possibility of VZV myelitis, even in immunocompetent patients. The combination of corticoids and acyclovir must be instituted, quickly, to improve functional outcome. PMID:21427667

  12. Kyrieleis plaques associated with Herpes Simplex Virus type 1 acute retinal necrosis

    Neha Goel

    2016-04-01

    Full Text Available We report the case of a 55-year-old immunocompetent male who presented with features typical of acute retinal necrosis (ARN. Polymerase chain reaction of the aqueous tap was positive for Herpes Simplex Virus (HSV – 1. Following therapy with intravenous Acyclovir, followed by oral Acyclovir and steroids, there was marked improvement in the visual acuity and clinical picture. At one week after initiation of treatment, Kyrieleis plaques were observed in the retinal arteries. They became more prominent despite resolution of the vitritis, retinal necrosis and vasculitis and persisted till six weeks of follow-up, when fluorescein angiography was performed. The appearance of this segmental retinal periarteritis also known as Kyrieleis plaques has not been described in ARN due to HSV-1 earlier.

  13. Management of Varicella Gangrenosa: A Life-Threatening Condition from Chickenpox

    Judith P. M. Schots

    2014-01-01

    Full Text Available Varicella gangrenosa, in which gangrenous ulceration of the skin and/or deeper tissues is seen, is a rare but alarming complication of Varicella infection. An early surgical intervention is generally advised, especially in case of sepsis and/or the presence of large necrotic lesions. We describe a case of a previously healthy 12-month-old boy presenting with sepsis due to Varicella gangrenosa. He presented with moderate lesions of moist gangrene. We treated our patient initially with antibiotics (ceftriaxone and metronidazole and later on flucloxacillin and antiviral therapy (acyclovir whereupon his condition rapidly improved and all skin lesions healed entirely. This report highlights the possibility of conservative treatment and emphasizes the significance of acyclovir in the management of chickenpox complicated by moist gangrene due to bacterial superinfection.

  14. Caulerpin as a potential antiviral drug against herpes simplex virus type 1

    Nathália Regina Porto Vieira Macedo

    2012-08-01

    Full Text Available About 80% of the human adult population is infected with HSV-1. Although there are many anti-HSV-1 drugs available (acyclovir, ganciclovir, valaciclovir, foscarnet, their continuous use promotes the selection of resistant strains, mainly in ACV patients. In addition to resistance, the drugs also have toxicity, particularly when administration is prolonged. The study of new molecules isolated from green algae with potential antiviral activity represents a good opportunity for the development of antiviral drugs. Caulerpin, the major product from the marine algae Caulerpa Lamouroux (Caulerpales, is known for its biological activities such as antioxidant, antifungal, acetylcholinesterase inhibitor (AChE and antibacterial activity. In this work, we show that caulerpin could be an alternative to acyclovir as an anti-HSV-1 drug that inhibits the alpha and beta phases of the replication cycle.

  15. [Acute retinal necrosis].

    Lucke, K; Reinking, U; el-Hifnawi, E; Dennin, R H; Laqua, H

    1988-12-01

    The authors report on three patients with acute retinal necrosis who were treated with the virostatic agent Acyclovir and who underwent vitreoretinal surgery with silicone oil filling for total retinal detachment. In two eyes the retina was reattached, but useful vision was only preserved in one patient. Titers from blood and the vitreous, as well as microscopic findings in retinal biopsies, support the view that the necrosis is caused by a herpes simplex virus infection. After therapy with Acyclovir was instituted no further progression on the necrosis was observed. However, the development of retinal detachment could not be prevented. Early diagnosis and antiviral therapy are essential to improve the otherwise poor prognosis in this rare syndrome. PMID:3221657

  16. Pyrimidine and nucleoside gamma-esters of L-Glu-Sar

    Eriksson, André H; Elm, Peter L; Begtrup, Mikael;

    2005-01-01

    permeable supports. Affinity was estimated in a competition assay, using [14C] labelled Gly-Sar (glycylsarcosine). Translocation was measured as pHi-changes induced by the substrates using the fluorescent probe BCECF and an epifluorescence microscope setup. All dipeptide derivatives released the model drugs...... compounds showed good affinity to hPEPT1, but the Compounds I and III showed not to be translocated by hPEPT1. The translocation of the l-Glu-Sar derivative of acyclovir, l-Glu(acyclovir)-Sar was also investigated and showed not to take place. Consequently, l-Glu-Sar seems to be a poor pro-moiety for hPEPT1...

  17. Downregulation of Cellular c-Jun N-Terminal Protein Kinase and NF-κB Activation by Berberine May Result in Inhibition of Herpes Simplex Virus Replication

    Song, Siwei; Qiu, Min; Chu, Ying; Chen, Deyan; Wang, Xiaohui; Su, Airong; Wu, Zhiwei

    2014-01-01

    Berberine is a quaternary ammonium salt from the protoberberine group of isoquinoline alkaloids. Some reports show that berberine exhibits anti-inflammatory, antitumor, and antiviral properties by modulating multiple cellular signaling pathways, including p53, nuclear factor κB (NF-κB), and mitogen-activated protein kinase. In the present study, we investigated the antiviral effect of berberine against herpes simplex virus (HSV) infection. Current antiherpes medicines such as acyclovir can le...

  18. TDP1 repairs nuclear and mitochondrial DNA damage induced by chain-terminating anticancer and antiviral nucleoside analogs

    Huang, Shar-yin N.; Murai, Junko; Dalla Rosa, Ilaria; Dexheimer, Thomas S.; Naumova, Alena; Gmeiner, William H.; Pommier, Yves

    2013-01-01

    Chain-terminating nucleoside analogs (CTNAs) that cause stalling or premature termination of DNA replication forks are widely used as anticancer and antiviral drugs. However, it is not well understood how cells repair the DNA damage induced by these drugs. Here, we reveal the importance of tyrosyl–DNA phosphodiesterase 1 (TDP1) in the repair of nuclear and mitochondrial DNA damage induced by CTNAs. On investigating the effects of four CTNAs—acyclovir (ACV), cytarabine (Ara-C), zidovudine (AZT...

  19. Hydrolyzable Tannins (Chebulagic Acid and Punicalagin) Target Viral Glycoprotein-Glycosaminoglycan Interactions To Inhibit Herpes Simplex Virus 1 Entry and Cell-to-Cell Spread▿

    Lin, Liang-Tzung; Chen, Ting-Ying; Chung, Chueh-Yao; Noyce, Ryan S.; Grindley, T. Bruce; McCormick, Craig; Lin, Ta-Chen; Wang, Guey-Horng; Lin, Chun-Ching; Richardson, Christopher D.

    2011-01-01

    Herpes simplex virus 1 (HSV-1) is a common human pathogen that causes lifelong latent infection of sensory neurons. Non-nucleoside inhibitors that can limit HSV-1 recurrence are particularly useful in treating immunocompromised individuals or cases of emerging acyclovir-resistant strains of herpesvirus. We report that chebulagic acid (CHLA) and punicalagin (PUG), two hydrolyzable tannins isolated from the dried fruits of Terminalia chebula Retz. (Combretaceae), inhibit HSV-1 entry at noncytot...

  20. Supra-recommendation Treatment of Super-refractory Status Epilepticus

    Vyas, Devashish Dhiren; Dash, Gopal Krishna

    2016-01-01

    A 28-year old female was admitted with recurrent seizures following 2 days of febrile illness, after which she developed status epilepticus. Midazolam and later thiopentone infusions were started after failure of regular intravenous antiepileptics. Burst suppression was achieved at doses of 3 mg/kg/hr for midazolam and 6 mg/kg/hr of thiopentone. Adjunctive medications included methylprednisolone, intravenous immunoglobulin and acyclovir. Imaging and biochemical parameters were normal. She req...

  1. Reactivation of herpes zoster along the trigeminal nerve with intractable pain after facial trauma: a case report and literature review

    Lin, K-C; Wang, Che-Chuan; Wang, Kai-Yuan; Liao, Yi-Chen; Kuo, Jinn-Rung

    2009-01-01

    We report the rare occurrence of herpes zoster reactivation after facial trauma. Herpes zoster appeared in painful groups of distended vesicles containing clear fluid on an erythematous base within the secondary division of the trigeminal nerve. The patient was treated with acyclovir (intravenous, 250 mg, every 8 hours) combined with topical steroids and anti-neuropathic pain medication. The zoster-associated neuralgia subsided gradually 1.5 months after diagnosis. We illustrate this unique c...

  2. Periorbital varicella gangrenosa: A rare complication of chicken pox

    Jagriti Jain; Shreya Thatte; Prakhar Singhai

    2015-01-01

    A previously healthy six year old male child presented in pediatrics ICU in state of shock with history of fever and rashes and later was diagnosed as chicken pox. He developed right sided periorbital varicella gangrenosa which is a form of necrotizing fasciitis secondary to skin infection. Patient was treated with intravenous acyclovir, antibiotics, amphotericin B, extensive debridement and later reconstruction of upper eyelid with skin grafting. Aggressive treatment helped preventing the ey...

  3. Anti-HSV activity of Hypnea musciformis cultured with different phytohormones

    Gabriella da Silva Mendes; Isolda Cecília Bravin; Yocie Yoneshigue-Valentin; Nair S. Yokoya; Maria Teresa Villela Romanos

    2012-01-01

    Four extracts from the seaweed Hypnea musciformis (Wulfen in Jacq.) J.V. Lamour. (Rhodophyta), collected directly from its natural habitat or cultivated in the presence of phytohormones, were evaluated for their ability to inhibit the replication of acyclovir-resistant herpes simplex viruses types 1 (HSV-1) and 2 (HSV-2) strains. The main purpose was to determinate whether these growth conditions would affect the antiviral activity. Our results showed the possibility of improving the anti-HSV...

  4. Varicella zoster virus infection causing urinary retention in a child with HIV infection

    G S Wessels; C. F. Heyns

    2012-01-01

    An 11-year-old boy receiving antiretroviral therapy for HIV infection and antibacterial therapy for pulmonary tuberculosis presented with urinary retention due to varicella zoster virus infection involving the sacral nerves, confirmed on serological testing. The perineum over dermatomes S2 - S4 on the left was involved with a vesicular and superficially erosive rash. A transurethral catheter was inserted and the patient was treated with acyclovir (300 mg 6-hourly for 5 days). At follow-up 4 w...

  5. Herpes simplex reactivation or postinfectious inflammatory response after epilepsy surgery: Case report and review of the literature

    Anna Lo Presti

    2015-01-01

    Conclusion: HSVE must be suspected in patients with previous history of HSVE and postoperative fever associated with an altered state of consciousness and/or seizures. Considering the high mortality and morbidity rates associated with HSVE, an adequate prophylactic administration of acyclovir should be considered for patients with previous history of HSVE undergoing neurosurgical procedures, especially when surgery involves the site of a previous herpetic lesion.

  6. Selective killing of CD4+ cells harboring a human immunodeficiency virus-inducible suicide gene prevents viral spread in an infected cell population.

    Caruso, M; Klatzmann, D

    1992-01-01

    We have stably expressed in CD4+ lymphoid cells the herpes simplex virus type 1 thymidine kinase (HSV1-TK) gene under the control of the human immunodeficiency virus (HIV) promoter and transactivation response element sequences. Upon HIV infection these regulatory sequences were transactivated, switching on high-level expression of HSV1-TK. This in turn caused the death of HIV-infected cells when they were cultured in the presence of acyclovir, a nucleoside analog that becomes toxic after pho...

  7. Association of progressive outer retinal necrosis and varicella zoster encephalitis in a patient with AIDS.

    van den Horn, G. J; Meenken, C; D. Troost

    1996-01-01

    BACKGROUND: A patient with AIDS who developed the clinical picture of bilateral progressive outer retinal necrosis (PORN) in combination with varicella zoster encephalitis is described. The picture developed more than 2 years after an episode of ophthalmic zoster infection, and following intermittent exposure to oral acyclovir because of recurrent episodes of cutaneous herpes simplex infection. METHODS: Aqueous humour, obtained by paracentesis of the anterior chamber, was analysed using immun...

  8. Peripheral Facial Paralysis and Apoptosis Induced by Herpes Simplex Type I Virus: A Rat Study

    Kabakuş, Nimet; ALPAY, H. Cengiz; GÖDEKMERDAN, Ahmet; GÖK, Üzeyir; Akpolat, Nusret

    2005-01-01

    Different results have been reported concerning the impact of agents used in the treatment of idiopathic facial nerve paralysis (FNP) generated by HSV type I (HSV-I) on the apoptotic process. We aimed at investigating the effects of different agents (steroids, acyclovir and interferon) used in the treatment of idiopathic FNP on the apoptotic process in animals in whom experimental FNP has been produced by HSV-I. After cleaning the auricles of 113 animals, linear injuries were produced, and th...

  9. Assessment of Pharmaceutical Equivalence: Difference Test or Equivalence Test?

    Lourenço, Felipe R.; Pinto, Terezinha J. A.

    2012-01-01

    Pharmaceutical equivalence is an important step towards the confirmation of similarity and interchangeability among pharmaceutical products, particularly regarding those that will not be tested for bioequivalence. The aim of this paper is to compare traditional difference testing to two one-side equivalence tests in the assessment of pharmaceutical equivalence, by means of equivalence studies between similar, generic and reference products of acyclovir cream, atropine sulfate injection, merop...

  10. Polyneuritis cranialis following herpes zoster

    Radhakrishna H

    2000-01-01

    Full Text Available Herpes zoster is a common clinical condition involving cranial nerves. We encountered 3 cases in which multiple cranial nerves were involved besides the commoner ones. All the three cases were treated with acyclovir and oral steroids. Recovery of motor function was only partial in all three cases when reviewed 2 months after discharge. The clinical details and a brief review of literature are presented.

  11. Antiviral Activity of Liquorice Powder Extract against Varicella Zoster Virus Isolated from Egyptian Patients

    Aly F. Mohamed; Essam H. Ibrahim; Amal S. Mostafa; Saad M. Bin Dajem; Magdy A. Amin; Amal Emad-Eldin; Rania I. Shebl

    2012-01-01

    Background: Varicella-zoster virus (VZV) is the etiologic agent of two diseases, varicella (chicken pox) and zoster (shingles). Varicella is a self- limited infection, while zoster is mainly a disease of adults. The present study was conducted to isolate VZV from clinically diagnosed children using cell cultures and compare the activity of liquorice powder extract, an alternative herbal antiviral agent, with acyclovir and interferon alpha 2a (IFN-α2a) against the isolated virus.Methods: Forty...

  12. Genital Herpes Has Played a More Important Role than Any Other Sexually Transmitted Infection in Driving HIV Prevalence in Africa

    Abu-Raddad, Laith J; Magaret, Amalia S; Celum, Connie; Wald, Anna; Longini, Ira M.; Self, Steven G.; Corey, Lawrence

    2008-01-01

    Background Extensive evidence from observational studies suggests a role for genital herpes in the HIV epidemic. A number of herpes vaccines are under development and several trials of the efficacy of HSV-2 treatment with acyclovir in reducing HIV acquisition, transmission, and disease progression have just reported their results or will report their results in the next year. The potential impact of these interventions requires a quantitative assessment of the magnitude of the synergy between...

  13. Varicella-zoster virus transverse myelitis in an immunocompetent patient

    Jemshad Alungal

    2014-06-01

    Full Text Available Transverse myelitis is one of the rare neurological complications of Varicella-Zoster Virus (VZV infection in immuno-competent. We report a 26-year-old immuno-competent gentleman who developed virologically confirmed myelopathy caused by VZV which improved with steroids and acyclovir leaving no residual neurological deficits. [Int J Res Med Sci 2014; 2(3.000: 1154-1156

  14. Update On Emerging Antivirals For The Management Of Herpes Simplex Virus Infections: A Patenting Perspective

    Vadlapudi, Aswani D.; Vadlapatla, Ramya K.; Ashim K. Mitra

    2013-01-01

    Herpes simplex virus (HSV) infections can be treated efficiently by the application of antiviral drugs. The herpes family of viruses is responsible for causing a wide variety of diseases in humans. The standard therapy for the management of such infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir. Though effective, long term prophylaxis with the current drugs leads to development of drug-resistant viral isolates, particularly i...

  15. [Severe thrombocytopenia associated with simultaneous cytomegalovirus and Epstein-barr virus infection in an immunocompetence patient].

    Bober, Grazyna; Krawczyk-Kuliś, Małgorzata; Kopera, Małgorzata; Hołowiecki, Jerzy

    2003-06-01

    A 22 year old woman, without preceeding immunological and hematological disorders was hospitalized because of severe thrombocytopenia. The results of extended workup revealed simultaneous cytomegalovirus and Epstein-Barr virus infection as the most probable causative factor. Both, thrombocytopenia and the symptoms of viral infections resolved after consequent treatment with acyclovir, corticosteroids and intravenous immunoglobulines. Based on this original case report authors suggest the need of virological tests in newly diagnosed idiopatic thrombocytopenia. PMID:14567095

  16. 3,19-isopropylideneandrographolide suppresses early gene expression of drug-resistant and wild type herpes simplex viruses.

    Kongyingyoes, Bunkerd; Priengprom, Thongkoon; Pientong, Chamsai; Aromdee, Chantana; Suebsasana, Supawadee; Ekalaksananan, Tipaya

    2016-08-01

    A diterpenoid lactone, 3,19-isopropylideneandrographolide (IPAD) compound isolated from Andrographis paniculata (Burm. f.) Nees, has been reported to inhibit herpes simplex virus type 1 (HSV-1) infection at the post-entry step. To identify the molecular target of IPAD, this study characterized the inhibitory effect of IPAD on infection of Vero cells by HSV-1, HSV-2 and a drug-resistant (DR) HSV-1 strain ACGr4 (acyclovir-resistant and thymidine kinase (TK)-deficient). Viral production, gene and protein expression were determined using plaque assays, quantitative RT-PCR and western blotting, respectively. The results showed that IPAD inhibited HSV-1, HSV-2 and DR-HSV-1 infections at 6-12 h post-infection, a time that corresponded with E gene expression. IPAD completely suppressed ICP8 transcription and translation as well as DNA replication and gD expression in the three strains tested, while acyclovir suppressed transcription and translation of UL30 and gD of HSV-2, HSV-1, but had no effect on DR-HSV-1. These results showed that IPAD has a different molecular target from acyclovir and might therefore be an alternative drug for HSV-1 and HSV-2 wild types and DR-HSV-1 strains. PMID:27424493

  17. Chronic urticaria associated with recurrent genital herpes simplex infection and success of antiviral therapy--a report of two cases.

    Zawar, Vijay; Godse, Kiran; Sankalecha, Sudhir

    2010-06-01

    The role of infectious agents as a cause of chronic idiopathic urticaria (CIU) is uncertain. The objective of this study was to investigate whether genital herpes simplex infection is causally related to CIU. We identified two patients with recurrent genital herpes simplex infections associated with CIU. Episodes of genital herpes were especially associated with acute exacerbation of urticaria. Anti-herpes simplex 2 antibodies and Tzanck smears were done in both patients, along with other relevant investigations for CIU. Acyclovir was added to antihistamine therapy. Both patients were apparently in good health and appeared clinically immunologically stable, though one of them was found to be diabetic. Clinical and laboratory investigations for genital lesions supported a diagnosis of herpes simplex. Anti-herpes simplex 2 antibodies were markedly raised in both patients. The Tzanck smear was positive in one case and negative in the other, despite a definitive clinical diagnosis of herpes progenitalis. CIU, which was inadequately controlled with antihistamines alone, responded dramatically to the addition of acyclovir therapy. Our results may not be applicable to other patients with CIU, especially when there is inadequate evidence of an association with genital herpes. CIU may be associated with recurrent genital herpes simplex infection. In such situations, the addition of acyclovir to therapy may be beneficial. PMID:19699670

  18. Validação de método de doseamento para aciclovir e aplicação em estudo de equivalência farmacêutica de creme contendo aciclovir

    Felipe Rebello Lourenço

    2010-06-01

    Full Text Available

    O presente trabalho teve por objetivos validar método para o doseamento de aciclovir em creme por espectrofotometria de absorção no ultravioleta e aplicá-lo em estudo de equivalência farmacêutica entre medicamento de referência, genérico e similar. O método proposto para doseamento de aciclovir em creme por espectrofotometria de absorção no ultravioleta foi validado, mostrando especificidade/ seletividade, linearidade e faixa linear, limite de detecção /quantificação, exatidão e precisão adequados para o uso pretendido. Os medicamentos foram avaliados quanto aos testes de peso médio, limite de guanina por cromatografia em camada delgada, identificação por espectrofotometria de absorção no ultravioleta, contagem microbiana de bactérias e fungos, pesquisa de microrganismos patógenos e doseamento por espectrofotometria de absorção no ultravioleta. Os três medicamentos atenderam as especificações para os testes avaliados e, portanto, podem ser considerados equivalentes farmacêuticos. Palavras-chave: Aciclovir. Validação de método. Equivalência farmacêutica. ABSTRACT Validation of acyclovir assay method and its use to verify pharmaceutical equivalence of creams containing acyclovir The aim of this study was to validate a UV absorption spectrophotometric method to assay acyclovir in cream and to use it to verify the pharmaceutical equivalence of the original brand-name, generic and similar (brand medicines. The method proposed for acyclovir cream was validated, showing adequate specificity/selectivity, linearity and linear range, detection and quantitation limits, accuracy and precision. The medicines were tested for average weight, guanine contents within limits (by thin-layer chromatography, drug identity (by UV spectrophotometry, bacterial and fungal counts and presence of pathogens, and were assayed by UV spectrophotometry. All medicines met the requirements in all these tests and can

  19. Solid dispersions in the form of electrospun core-sheath nanofibers

    Yu DG

    2011-12-01

    Full Text Available Deng-GuangYu1, Li-Min Zhu2, Christopher J Branford-White3, Jun-He Yang1, Xia Wang1, Ying Li1, Wei Qian11School of Materials Science and Engineering, University of Shanghai for Science and Technology; 2College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, People's Republic of China; 3Faculty of Life Sciences, London Metropolitan University, London, United KingdomBackground: The objective of this investigation was to develop a new type of solid dispersion in the form of core-sheath nanofibers using coaxial electrospinning for poorly water-soluble drugs. Different functional ingredients can be placed in various parts of core-sheath nanofibers to improve synergistically the dissolution and permeation properties of encapsulated drugs and to enable drugs to exert their actions.Methods: Using acyclovir as a model drug, polyvinylpyrrolidone as the hydrophilic filament-forming polymer matrix, sodium dodecyl sulfate as a transmembrane enhancer, and sucralose as a sweetener, core-sheath nanofibers were successfully prepared, with the sheath part consisting of polyvinylpyrrolidone, sodium dodecyl sulfate, and sucralose, and the core part composed of polyvinylpyrrolidone and acyclovir.Results: The core-sheath nanofibers had an average diameter of 410 ± 94 nm with a uniform structure and smooth surface. Differential scanning calorimetry and x-ray diffraction results demonstrated that acyclovir, sodium dodecyl sulfate, and sucralose were well distributed in the polyvinylpyrrolidone matrix in an amorphous state due to favoring of second-order interactions. In vitro dissolution and permeation studies showed that the core-sheath nanofiber solid dispersions could rapidly release acyclovir within one minute, with an over six-fold increased permeation rate across the sublingual mucosa compared with that of crude acyclovir particles.Conclusion: The study reported here provides an example of the systematic design, preparation

  20. Antiviral Activity of Liquorice Powder Extract against Varicella Zoster Virus Isolated from Egyptian Patients

    Aly F. Mohamed

    2012-06-01

    Full Text Available Background: Varicella-zoster virus (VZV is the etiologic agent of two diseases, varicella (chicken pox and zoster (shingles. Varicella is a self- limited infection, while zoster is mainly a disease of adults. The present study was conducted to isolate VZV from clinically diagnosed children using cell cultures and compare the activity of liquorice powder extract, an alternative herbal antiviral agent, with acyclovir and interferon alpha 2a (IFN-α2a against the isolated virus.Methods: Forty-eight VZV specimens, 26 from vesicular aspirates and 22 from vesicular swabs, from children clinically diagnosed with varicella were isolated on the Vero cell line. Isolates were propagated and identified with specific antiserum using indirect immunofluorescence and immunodot blotting assays.The growth kinetics of the viral isolates was studied. The antiviral activity of liquorice powder extract, acyclovir (ACV and IFN-α2a was evaluated against the isolated virus.Results: VZV was successfully isolated in 4 of the 48 specimens, all from vesicular aspirates. The growth kinetics of the viral isolates was time dependent. The inhibitory activity of liquorice powder extract (containing 125 µg/ml glycyrrhizin when compared to ACV (250 µg/ml and IFN-α2a is the lowest.Conclusions: VZV isolates were successfully isolated and propagated using Vero cells. Isolates were identified using indirect immunofluorescent and immunodot blotting techniques. Growth kinetics of the isolates revealed an increase in the viral infectivity titer relative to time. Glycyrrhizin in the crude form has low antiviral activity against VZV compared with acyclovir and interferon.

  1. Acute Retinal Necrosis in Childhood

    Yoav Y. Pikkel

    2014-05-01

    Full Text Available Background: Acute retinal necrosis (ARN is a viral syndrome consisting of uveitis/vitritis, occlusive vasculitis and peripheral necrosis. Few incidents are reported in children. The etiology is reactivated herpes simplex virus (HSV or varicella-zoster virus (VZV. Treatment with acyclovir is often used. The administration of oral glucocorticosteroids is of unproven benefit. Prognosis is variable but poor. Methods: Three weeks after contracting mild chickenpox, a healthy 4-year-old girl developed blurred vision in her right eye. Severely reduced visual acuity was noted, together with anterior uveitis, ‘mutton-fat' precipitates and vitral flare. Retinal vasculitis with necrosis was present. Serology for toxoplasma, cytomegalovirus and HIV was negative, while HSV and VZV IgG antibodies were positive. She was treated with 30 mg/kg of intravenous methylprednisolone (3 days, 30 mg of oral prednisone (3 days, and tapering for 8 weeks. Intravenous acyclovir was given for 10 days, followed by oral acyclovir for 4 months. Aspirin (100 mg/day was given for 4 months. Results: At 12 months, the girl felt good. Her right eye acuity was 6/9, with an intraocular pressure of 17 mm Hg. The peripheral retina showed scarring but no detachment. Conclusions: This is the first report of a once-daily high-dose methylprednisolone pulse therapy in one of the youngest known ARN cases. Pulsed steroid therapy was based on its known effectiveness in vasculitis, which is the main pathophysiology in ARN. There was no evidence of steroid-related viral over-replication. Our case achieved an excellent clinical and ophthalmic recovery in spite of the poor prognosis. The positive result of this case report provides a basis for further evaluation of high-dose steroid pulse therapy in ARN.

  2. Cocrystals of 5-fluorocytosine. I. Coformers with fixed hydrogen-bonding sites.

    Tutughamiarso, Maya; Wagner, Guido; Egert, Ernst

    2012-08-01

    The antifungal drug 5-fluorocytosine (4-amino-5-fluoro-1,2-dihydropyrimidin-2-one) was cocrystallized with five complementary compounds in order to better understand its drug-receptor interaction. The first two compounds, 2-aminopyrimidine (2-amino-1,3-diazine) and N-acetylcreatinine (N-acetyl-2-amino-1-methyl-5H-imidazol-4-one), exhibit donor-acceptor sites for R(2)(2)(8) heterodimer formation with 5-fluorocytosine. Such a heterodimer is observed in the cocrystal with 2-aminopyrimidine (I); in contrast, 5-fluorocytosine and N-acetylcreatinine [which forms homodimers in its crystal structure (II)] are connected only by a single hydrogen bond in (III). The other three compounds 6-aminouracil (6-amino-2,4-pyrimidinediol), 6-aminoisocytosine (2,6-diamino-3H-pyrimidin-4-one) and acyclovir [acycloguanosine or 2-amino-9-[(2-hydroxyethoxy)methyl]-1,9-dihydro-6H-purin-6-one] possess donor-donor-acceptor sites; therefore, they can interact with 5-fluorocytosine to form a heterodimer linked by three hydrogen bonds. In the cocrystals with 6-aminoisocytosine (Va)-(Vd), as well as in the cocrystal with the antiviral drug acyclovir (VII), the desired heterodimers are observed. However, they are not formed in the cocrystal with 6-aminouracil (IV), where the components are connected by two hydrogen bonds. In addition, a solvent-free structure of acyclovir (VI) was obtained. A comparison of the calculated energies released during dimer formation helped to rationalize the preference for hydrogen-bonding interactions in the various cocrystal structures. PMID:22810913

  3. Varicella-zoster virus infections in immunocompromised patients - a single centre 6-years analysis

    Liese Johannes

    2011-05-01

    Full Text Available Abstract Background Infection with varicella-zoster virus (VZV contemporaneously with malignant disease or immunosuppression represents a particular challenge and requires individualized decisions and treatment. Although the increasing use of varicella-vaccines in the general population and rapid initiation of VZV-immunoglobulins and acyclovir in case of exposure has been beneficial for some patients, immunocompromised individuals are still at risk for unfavourable courses. Methods In this single center, 6-year analysis we review incidence, hospitalization and complication rates of VZV-infections in our center and compare them to published data. Furthermore, we report three instructive cases. Results Hospitalization rate of referred children with VZV-infections was 45%, among these 17% with malignancies and 9% under immunosuppressive therapy. Rate of complications was not elevated in these two high-risk cohorts, but one ALL-patient died due to VZV-related complications. We report one 4-year old boy with initial diagnosis of acute lymphoblastic leukemia who showed a rapidly fatal outcome of his simultaneous varicella-infection, one 1.8-year old boy with an identical situation but a mild course of his disease, and an 8.5-year old boy with a steroid-dependent nephrotic syndrome. This boy developed severe hepatic involvement during his varicella-infection but responded to immediate withdrawl of steroids and administration of acyclovir plus single-dose cidofovir after nonresponse to acyclovir after 48 h. Conclusion Our data show that patients with malignant diseases or immunosuppressive therapy should be hospitalized and treated immediately with antiviral agents. Despite these measures the course of VZV-infections can be highly variable in these patients. We discuss aids to individual decision-making for these difficult situations.

  4. Corticosteroid and antiviral therapy for Bell's palsy: A network meta-analysis

    Attia John

    2011-01-01

    Full Text Available Abstract Background Previous meta-analyses of treatments for Bell's palsy are still inconclusive due to different comparators, insufficient data, and lack of power. We therefore conducted a network meta-analysis combining direct and indirect comparisons for assessing efficacy of steroids and antiviral treatment (AVT at 3 and 6 months. Methods We searched Medline and EMBASE until September 2010 using PubMed and Elsviere search engines. A network meta-analysis was performed to assess disease recovery using a mixed effects hierarchical model. Goodness of fit of the model was assessed, and the pooled odds ratio (OR and 95% confidence interval (CI were estimated. Results Six studies (total n = 1805were eligible and contributed to the network meta-analysis. The pooled ORs for resolution at 3 months were 1.24 (95% CI: 0.79 - 1.94 for Acyclovir plus Prednisolone and 1.02 (95% CI: 0.73 - 1.42 for Valacyclovir plus Prednisolone, versus Prednisolone alone. Either Acyclovir or Valacyclovir singly had significantly lower efficacy than Prednisolone alone, i.e., ORs were 0·44 (95% CI: 0·28 - 0·68 and 0·60 (95% CI: 0·42 - 0·87, respectively. Neither of the antiviral agents was significantly different compared with placebo, with a pooled OR of 1·25 (95% CI: 0·78 - 1·98 for Acyclovir and 0·91 (95% CI: 0·63 - 1·31 for Valacyclovir. Overall, Prednisolone-based treatment increased the chance of recovery 2-fold (95% CI: 1·55 - 2·42 compared to non-Prednisolone-based treatment. To gain 1 extra recovery, 6 and 26 patients need to be treated with Acyclovir and prednisolone compared to placebo and prednisolone alone, respectively. Conclusions Our evidence suggests that the current practice of treating Bell's palsy with AVT plus corticosteroid may lead to slightly higher recovery rates compared to treating with prednisone alone but this does not quite reach statistical significance; prednisone remains the best evidence-based treatment.

  5. Herpes simplex encephalitis -A case series

    MANJU, Jyotir; Patil, Shruti; RAU, ATK

    2012-01-01

    The prognosis of Herpes simplex encephalitis (HSE) depends on the early and appropriate administration of specific antiviral therapy. We retrospectively reviewed 42 children with acute CNS infection, over a period of 18 months, of which 4 were positive for HSV antibodies. All four showed CSF pleocytosis, with mildly elevated protein and rising titers of antibodies to HSV in the CSF. All the 4 cases were started on i.v. acyclovir on day 1 and continued for a total duration of 14 days. The pati...

  6. Fatal varicella hepatitis in an asthmatic adult after short-term corticosteroid treatment.

    Hyvernat, Hervé; Roger, Pierre-Marie; Pereira, Cécile; Saint-Paul, Marie Christine; Vandenbos, Frédéric; Bernardin, Gilles

    2005-09-01

    A 28-year-old male patient, treated with prednisone for bronchitis with sibilant rales, developed fever with abdominal pain and generalized vesicular rash after coming in contact with varicella-infected children. He was hospitalized after having a seizure. Laboratory values revealed hepatitis and rapidly fulminant hepatic insufficiency with disseminated intravascular coagulation. Despite acyclovir treatment, the patient died 4 days after admission. Clinical presentation could evoke a Reye's syndrome, but liver biopsy showed massive coagulative necrosis. This report demonstrates the increased risk of complicated varicella associated with the use of corticosteroids, even for a short period of time. PMID:16137553

  7. Cutaneous neonatal herpes simplex virus infection type 2: a case report*

    Bittencourt, Maraya de Jesus Semblano; Freitas, Lívia Karlla Marinho; Drago, Marion Guimarães; Carvalho, Alessandra Haber; do Nascimento, Bianca Angelina Macêdo

    2016-01-01

    Neonatal herpes is a serious condition. Newborns can be contaminated in utero via transplacental hematogenic transmission, upon delivery (the most frequent route), or during the postnatal period (indirect transmission). Optimal management requires prompt and accurate recognition, particularly in newborns, in order to prevent complications. Acyclovir is the treatment of choice, but its implementation is often delayed while awaiting test results, such as PCR and serology. Cytology for diagnostic purposes is rarely used in dermatology, despite the quick and reliable results. We report a case of neonatal herpes caused by type 2 herpes simplex virus diagnosed by cytology. PMID:27192523

  8. Diffusion-weighted MR imaging findings in a patient with herpes simplex encephalitis

    Introduction: Herpes simplex meningoencephalitis is one of the most common viral central nervous system infection in adults. Early diagnosis is essential for treatment. Case report: We present a case of a 68-year-old female patient with herpes simplex infection. On admission, she was in severe clinical condition. Diffusion-weighted (DW) magnetic resonance imaging detected brain involvement better than conventional sequences. After acyclovir therapy, the patient fully recovered. Conclusion: DW magnetic resonance imaging is expected to provide a more sensitive imaging in herpes simplex patients than conventional sequences

  9. Herpes simplex encephalitis

    Early institution of therapy with acyclovir is essential for the successful outcome in herpes simplex encephalitis. Brain biopsy remains the only conclusive means of establishing the diagnosis, but many fear possible biobsy complications. Thus, therapy is often instituted when the diagnosis is clinically suspected, even though cerebral computed tomography and other diagnostic studies may be inconclusive. Nuclear magnetic resonance imaging (NMR) has proven to be a sensitive tool for diagnosing presumptive herpes simplex encephalitis. This case presentation demonstrates the superiority of cerebral NMR over computerized tomography for detecting early temporal lobe changes consistent with acute herpes simplex encephalitis

  10. Acute liver failure due to Varicella zoster virus infection after lung transplantation: a case report.

    Verleden, G M; Vos, R; Van Raemdonck, D E; Laleman, W; Vanaudenaerde, B M

    2012-06-01

    Most adults are Varicella zoster virus (VZV)-positive at the age of 20 years. Some, however, remain antibody-negative and may develop primary chicken pox during adulthood. We report a patient with Williams-Campbell syndrome who underwent double-lung transplantation while being VZV-negative. One year after the successful procedure, he was admitted with fulminant hepatic failure and some cutaneous vesicles in his face. Despite a rapid diagnosis of VZV infection and treatment with acyclovir, his situation deteriorated within 24 hours and while awaiting an urgent liver transplantation, he developed multiple organ failure and died. PMID:22664036

  11. Rapid quantification of the metabolite of valacyclovir hydrochloride in human plasma by liquid chromatography-tandem mass spectrometry

    2010-01-01

    Objective To establish a rapid,sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of acyclovir (the metabolite of valacyclovir hydrochloride) in human plasma. Methods After addition of ganciclovir as internal standard (IS),plasma samples were prepared by one-step protein precipitation using acetonitrile as precipitant,followed by an isocratic elution with 0.1% formic acid solution-methanol (95∶5,v/v) on an Agilent ZORBAX SB-C18 (150mm×2.1mm i.d.,3....

  12. Characterization of anti-herpes simplex virus type 1 activity of an alkaloid FK 3000 from Stephania cepharantha

    Hattori, Masao; Ohsaki, Motoki; Kurokawa, Masahiko; NAWAWI, As'ari; Nakamura, Norio; Shiraki, Kimiyasu

    2002-01-01

    A morphinane alkaloid FK 3000 (6,7-di-O-acetylsinococuline) from the root tubers of Stephania cepharantha showed antiviral activity against acyclovir (ACV)- and phosphonoacetic acid (PAA)-resistant herpes simplex virus type 1 (HSV-1), influenza virus, measles virus, and poliovirus. The anti-HSV action of FK 3000 was assessed in comparison with that of PAA that inhibits the activity of HSV DNA polymerase and HSV DNA synthesis. FK 3000 inhibited the growth of thymidine kinase-deficient and ACV ...

  13. An Unusual Presentation of Herpes Simplex Virus Encephalitis

    Ray Boyapati

    2012-01-01

    Full Text Available We present a case of a 65-year-old man with an acute alteration in mental state that was initially diagnosed as a functional psychiatric condition. After extensive workup, herpes simplex virus type 1 (HSV-1 was detected in the patient’s cerebrospinal fluid (CSF by polymerase chain reaction (PCR, and he responded rapidly to treatment with acyclovir. The case illustrates the importance of actively excluding organic causes in such patients, the need to have a low threshold of suspicion for HSV encephalitis, and the central role of CSF PCR testing for the diagnosis of HSV encephalitis, even in the absence of CSF biochemical abnormalities.

  14. Varicella zoster virus infection causing urinary retention in a child with HIV infection

    G S Wessels

    2012-11-01

    Full Text Available An 11-year-old boy receiving antiretroviral therapy for HIV infection and antibacterial therapy for pulmonary tuberculosis presented with urinary retention due to varicella zoster virus infection involving the sacral nerves, confirmed on serological testing. The perineum over dermatomes S2 - S4 on the left was involved with a vesicular and superficially erosive rash. A transurethral catheter was inserted and the patient was treated with acyclovir (300 mg 6-hourly for 5 days. At follow-up 4 weeks later, the perineal skin lesions had healed, the catheter was removed and the patient was able to pass urine.

  15. Herpes Zoster Infection Involving Mandibular Division of Trigeminal Nerve and Ramsay Hunt Syndrome with Meningitis in an Immunocompetent Patient: A Rare Association.

    Ganesan, Vijayan; Bandyopadhyay, Dhrubajyoti; Kar, Suvrendu Sankar; Choudhury, Cankatika; Choudhary, Vivek

    2016-06-01

    Herpes zoster is a unilateral painful vesicular cutaneous eruption caused by the reactivation of the Varicella zoster virus. It commonly affects the older people and immunocompromised individuals. The dermatomes from T3 to L3 are most frequently involved. Its three stages include prodromal stage, active stage and chronic stage. The common complications of the infection include post-herpetic neuralgia, Ramsay Hunt syndrome, Guillain-Barre syndrome, transverse myelitis and encephalomyelitis. This case report summarizes a very rare association of herpes zoster meningitis with the involvement of mandibular division of the trigeminal nerve and facial nerve. The patient improved with intravenous acyclovir and prednisolone treatment. PMID:27504334

  16. Herpes simplex virus hepatitis 4 years after liver transplantation.

    Bissig, Karl-Dimiter; Zimmermann, Arthur; Bernasch, Dirke; Furrer, Hansjakob; Dufour, Jean-FranCois

    2003-01-01

    If not promptly recognized and treated, herpes simplex virus (HSV) hepatitis is associated with a high mortality. A patient transplanted for primary sclerosing cholangitis required, 4 years later, a colectomy for a steroid-resistant flare of ulcerative colitis. He subsequently developed fever, with genital and oral ulcerations. He was hospitalized for diabetic decompensation with massive elevation of serum aminotransferases. Examination revealed vesicles on the hands. Liver biopsy showed Cowdry type B inclusions. Therapy with acyclovir was immediately initiated and the patient recovered. This case illustrates the diagnostic importance of mucocutaneous lesions in the assessment of complications after liver transplantation. PMID:14614611

  17. A case of herpes zoster associated with colitis.

    Okimura, H; Muto, M; Ichimiya, M; Mogami, S; Takahata, H; Asagami, C

    1996-09-01

    A 58-year-old Japanese woman who had herpes zoster in association with colitis was successfully treated with intravenously administrated acyclovir. Vesicular lesions with red haloes ranged from the left side of her buttock to the left extremity, corresponding to the L4 to S2 dermatomes. Her colitis was considered to have been induced by varicella-zoster virus, based on the facts that the clinical courses were correlated and that the innervation of the affected site of the colon corresponded to an infected dermatome (S2). PMID:8916665

  18. Antioxidant and antiviral properties of Pseudopiptadenia contorta (Leguminosae and of quebracho (Schinopsis sp. extracts

    Davyson de L. Moreira

    2005-06-01

    Full Text Available Proanthocyanidins from P. contorta leaves and from a commercial quebracho extract were isolated and characterized. Flavonoids, catechins and gallic acid were also identified in the extracts of P. contorta. Compounds were evaluated for their antioxidant properties and for their antiviral activity against an acyclovir-resistant herpes simplex virus type 1 strain. The low molecular weight phenolic derivatives and the proanthocyanidins from P. contorta showed the highest antioxidant activity. Purified proanthocyanidins from both P. contorta and quebracho showed the same maximum non toxic concentrations (25 µg/mL, with 82.2% and 100% of virus inhibition, respectively.

  19. An unusual case of acute transverse myelitis caused by HSV-1 infection.

    Figueroa, Danisha; Isache, Carmen; Sands, Michael; Guzman, Nilmarie

    2016-01-01

    Transverse myelitis is a neurological disorder of the spinal cord that can have a variety of etiologies. Herpes simplex virus (HSV) infection has been described as one of the causes, most commonly HSV type 2. We report here a case of an 18 year old male who presented with weakness that started in his upper extremities and rapidly evolved to quadriplegia. Magnetic resonance imaging of spine was consistent with transverse myelitis. HSV type 1 PCR testing on cerebrospinal fluid (CSF) was positive. He was started on acyclovir and steroids, but despite therapy, patient did not recover motor function. PMID:27419072

  20. Successful rescue of disseminated varicella infection with multiple organ failure in a pediatric living donor liver transplant recipient: a case report and literature review.

    Yamada, Naoya; Sanada, Yukihiro; Okada, Noriki; Wakiya, Taiichi; Ihara, Yoshiyuki; Urahashi, Taizen; Mizuta, Koichi

    2015-01-01

    A 12-year-old female patient with biliary atresia underwent living donor liver transplantation (LDLT). Twelve months after the LDLT, she developed acute hepatitis (alanine aminotransferase 584 IU/L) and was diagnosed with disseminated varicella-zoster virus (VZV) infection with high level of serum VZV-DNA (1.5 × 10(5) copies/mL) and generalized vesicular rash. She had received the VZV vaccination when she was 5-years-old and had not been exposed to chicken pox before the LDLT, and her serum was positive for VZV immunoglobulin G at the time of the LDLT. Although she underwent treatment with intravenous acyclovir, intravenous immunoglobulin, and withdrawal of immunosuppressants, her symptoms worsened and were accompanied by disseminated intravascular coagulation, pneumonia, and encephalitis. These complications required treatment in the intensive care unit for 16 days. Five weeks later, her clinical findings improved, although her VZV-DNA levels remained high (8.5 × 10(3)copies/mL). Oral acyclovir was added for 2 weeks, and she was eventually discharged from our hospital on day 86 after admission; she has not experienced a recurrence. In conclusion, although disseminated VZV infection with multiple organ failure after pediatric LDLT is a life-threatening disease, it can be cured via an early diagnosis and intensive treatment. PMID:26081644

  1. A rare complication of Ramsey Hunt Syndrome: Sınus vein thrombosis

    Ramiz Ahmedov

    2011-03-01

    Full Text Available Ramsay-Hunt Syndrome (RHS is a rare affection characterized by peripheral facial paralysis (PFP, skin eruption in the auricular canal and cochleovestibular symptoms. It is produced by varicella-zoster virus(VZV reactivation at the geniculate ganglia. In elderly and immunocompromised individuals, the virus may reactivate to produce shingles (zoster. After zoster resolves, many elderly patients experience postherpetic neuralgia. Uncommonly, VZV can spread to large cerebral arteries to cause a spectrum of large-vessel vascular damage, ranging from vasculopathy to vasculitis, with stroke. In immunocompromised individuals, especially those with cancer or acquired immunodeficiency syndrome, deeper tissue penetration of the virus may occur (as compared with immunocompetent individuals, with resultant myelitis, small-vessel vasculopathy, ventriculitis, and meningoencephalitis. The polymerase chain reaction (PCR analysis of cerebrospinal fluid remains the mainstay for diagnosing the neurologic complications of VZV during life. We report a case of Ramsay Hunt syndrome complicated with cerebral venous thrombosis. Patient received treatment with acyclovir and anticoagulation. Early treatment with acyclovir therapy and anticoagulation could improve the recovery rate of facial nerve palsy and sinus vein thrombosis.

  2. Development of a paediatric population pharmacokinetic model for valacyclovir from literature non-compartmental values originating from sparse studies and Bayesian priors: a simulation study.

    Kechagia, Irene-Ariadne; Dokoumetzidis, Aristides

    2015-06-01

    A preliminary population pharmacokinetic (PopPK) model of valacyclovir in children was developed from non-compartmental analysis (NCA) parameter values from literature, including several age groups, combined with Bayesian priors from a PopPK model of acyclovir, the active metabolite of valacyclovir, from literature too. Also a simulation study was carried out to evaluate the performance of various modelling choices related to the estimation of model parameters from NCA parameters originating from sparse PK studies. Assuming a one-compartment model with first order absorption, a mixed effects, meta-analysis approach was utilized which allows accounting the random intergroup variability, the detection of covariates and the application of informative Bayesian priors on the parameters. The conclusions from the simulation study calculating bias and precision for various cases, were that a model which takes explicitly into account the sampling schedule, performs better than a model using the theoretical expressions of calculating the NCA parameters. Also by using the geometric rather than the arithmetic means of NCA parameters, less biased results are obtained. These findings guided the choices for the valacyclovir model, for which informative priors from a PopPK model of acyclovir were applied for some of the parameters, in order to include a richer covariate model for clearance, not supported by the NCA dataset and a value for bioavailability. This preliminary valacyclovir model can be used in simulations to provide dosage recommendations for children of various ages and to help design more efficiently prospective clinical trials. PMID:25821006

  3. Spectrum of activity and mechanisms of resistance of various nucleoside derivatives against gammaherpesviruses.

    Coen, Natacha; Duraffour, Sophie; Topalis, Dimitri; Snoeck, Robert; Andrei, Graciela

    2014-12-01

    The susceptibilities of gammaherpesviruses, including Epstein-Barr virus (EBV), Kaposi's sarcoma-associated herpesvirus (KSHV), and animal rhadinoviruses, to various nucleoside analogs was investigated in this work. Besides examining the antiviral activities and modes of action of antivirals currently marketed for the treatment of alpha- and/or betaherpesvirus infections (including acyclovir, ganciclovir, penciclovir, foscarnet, and brivudin), we also investigated the structure-activity relationship of various 5-substituted uridine and cytidine molecules. The antiviral efficacy of nucleoside derivatives bearing substitutions at the 5 position was decreased if the bromovinyl was replaced by chlorovinyl. 1-β-D-Arabinofuranosyl-(E)-5-(2-bromovinyl)uracil (BVaraU), a nucleoside with an arabinose configuration of the sugar ring, exhibited no inhibitory effect against rhadinoviruses but was active against EBV. On the other hand, the fluoroarabinose cytidine analog 2'-fluoro-5-iodo-aracytosine (FIAC) showed high selectivity indices against gammaherpesviruses that were comparable to those of brivudin. Additionally, we selected brivudin- and acyclovir-resistant rhadinoviruses in vitro and characterized them by phenotypic and genotypic (i.e., sequencing of the viral thymidine kinase, protein kinase, and DNA polymerase) analysis. Here, we reveal key amino acids in these enzymes that play an important role in substrate recognition. Our data on drug susceptibility profiles of the different animal gammaherpesvirus mutants highlighted cross-resistance patterns and indicated that pyrimidine nucleoside derivatives are phosphorylated by the viral thymidine kinase and purine nucleosides are preferentially activated by the gammaherpesvirus protein kinase. PMID:25267682

  4. Facial herpes zoster infection precipitated by surgical manipulation of the trigeminal nerve during exploration of the posterior fossa: a case report

    Mansour Nassir

    2009-09-01

    Full Text Available Abstract Introduction We present a case of herpes zoster infection (shingles precipitated by surgical manipulation of the trigeminal nerve root during an attempted microvascular decompression procedure. The pathogenesis of this phenomenon, as well as the importance and role of prophylactic acyclovir in its management, are discussed. Case presentation A 54-year-old Caucasian man with a classical long-standing left-sided V2 and V3 division primary trigeminal neuralgia refractory to medical management, underwent posterior fossa exploration for microvascular decompression via a standard retromastoid craniectomy. The patient had immediate and complete relief from pain. Three days after the operation, he developed severely painful vesicles with V2 and V3 dermatomal distribution. Rather than the classical paroxysmal, lancinating type of trigeminal neuralgia, the pain experienced by the patient was of a constant burning nature. A clinical diagnosis of herpes zoster (shingles was made after smear confirmation from microbiological testing. The patient was commenced on antiviral treatment with acyclovir. His vesicular rash and pain gradually subsided over the next two weeks. He remains asymptomatic one year later. Conclusions Postoperative shingles precipitated by trigeminal nerve manipulation during surgery for trigeminal neuralgia can be a distressing and demoralizing experience for the patient. A careful preoperative history, early recognition, and prompt antiviral therapy is necessary.

  5. Management of ramsay hunt syndrome in an acute palliative care setting

    Shrenik Ostwal

    2015-01-01

    Full Text Available Introduction: The Ramsay Hunt syndrome is characterized by combination of herpes infection and lower motor neuron type of facial nerve palsy. The disease is caused by a reactivation of Varicella Zoster virus and can be unrepresentative since the herpetic lesions may not be always be present (zoster sine herpete and might mimic other severe neurological illnesses. Case Report: A 63-year-old man known case of carcinoma of gall bladder with liver metastases, post surgery and chemotherapy with no scope for further disease modifying treatment, was referred to palliative care unit for best supportive care. He was on regular analgesics and other supportive treatment. He presented to Palliative Medicine outpatient with 3 days history of ipsilateral facial pain of neuropathic character, otalgia, diffuse vesciculo-papular rash over ophthalmic and maxillary divisions of left trigeminal nerve distribution of face and ear, and was associated with secondary bacterial infection and unilateral facial edema. He was clinically diagnosed to have Herpes Zoster with superadded bacterial infection. He was treated with tablet Valacyclovir 500 mg four times a day, Acyclovir cream for local application, Acyclovir eye ointment for prophylactic treatment of Herpetic Keratitis, low dose of Prednisolone, oral Amoxicillin and Clindamycin for 7 days, and Pregabalin 150 mg per day. After 7 days of treatment, the rash and vesicles had completely resolved and good improvement of pain and other symptoms were noted. Conclusion: Management of acute infections and its associated complications in an acute palliative care setting improves both quality and length of life.

  6. Houttuynia cordata targets the beginning stage of herpes simplex virus infection.

    Pei-Yun Hung

    Full Text Available Herpes simplex virus (HSV, a common latent virus in humans, causes certain severe diseases. Extensive use of acyclovir (ACV results in the development of drug-resistant HSV strains, hence, there is an urgent need to develop new drugs to treat HSV infection. Houttuynia cordata (H. cordata, a natural herbal medicine, has been reported to exhibit anti-HSV effects which is partly NF-κB-dependent. However, the molecular mechanisms by which H. cordata inhibits HSV infection are not elucidated thoroughly. Here, we report that H. cordata water extracts (HCWEs inhibit the infection of HSV-1, HSV-2, and acyclovir-resistant HSV-1 mainly via blocking viral binding and penetration in the beginning of infection. HCWEs also suppress HSV replication. Furthermore, HCWEs attenuate the first-wave of NF-κB activation, which is essential for viral gene expressions. Further analysis of six compounds in HCWEs revealed that quercetin and isoquercitrin inhibit NF-κB activation and additionally, quercetin also has an inhibitory effect on viral entry. These results indicate that HCWEs can inhibit HSV infection through multiple mechanisms and could be a potential lead for development of new drugs for treating HSV.

  7. Antiviral activity of the Lippia graveolens (Mexican oregano) essential oil and its main compound carvacrol against human and animal viruses.

    Pilau, Marciele Ribas; Alves, Sydney Hartz; Weiblen, Rudi; Arenhart, Sandra; Cueto, Ana Paula; Lovato, Luciane Teresinha

    2011-10-01

    Mexican oregano (Lippia graveolens) is a plant found in Mexico and Central America that is traditionally used as a medicinal herb. In the present study, we investigated the antiviral activity of the essential oil of Mexican oregano and its major component, carvacrol, against different human and animal viruses. The MTT test (3-4,5-dimethythiazol-2yl)-2,5-diphenyl tetrazolium bromide) was conducted to determine the selectivity index (SI) of the essential oil, which was equal to 13.1, 7.4, 10.8, 9.7, and 7.2 for acyclovir-resistant herpes simplex virus type 1 (ACVR-HHV-1), acyclovir-sensitive HHV-1, human respiratory syncytial virus (HRSV), bovine herpesvirus type 2 (BoHV-2), and bovine viral diarrhoea virus (BVDV), respectively. The human rotavirus (RV) and BoHV-1 and 5 were not inhibited by the essential oil. Carvacrol alone exhibited high antiviral activity against RV with a SI of 33, but it was less efficient than the oil for the other viruses. Thus, Mexican oregano oil and its main component, carvacrol, are able to inhibit different human and animal viruses in vitro. Specifically, the antiviral effects of Mexican oregano oil on ACVR-HHV-1 and HRSV and of carvacrol on RV justify more detailed studies. PMID:24031796

  8. Antiviral activity of the Lippia graveolens (Mexican oregano essential oil and its main compound carvacrol against human and animal viruses

    Marciele Ribas Pilau

    2011-12-01

    Full Text Available Mexican oregano (Lippia graveolens is a plant found in Mexico and Central America that is traditionally used as a medicinal herb. In the present study, we investigated the antiviral activity of the essential oil of Mexican oregano and its major component, carvacrol, against different human and animal viruses. The MTT test (3-4,5-dimethythiazol-2yl-2,5-diphenyl tetrazolium bromide was conducted to determine the selectivity index (SI of the essential oil, which was equal to 13.1, 7.4, 10.8, 9.7, and 7.2 for acyclovir-resistant herpes simplex virus type 1 (ACVR-HHV-1, acyclovir-sensitive HHV-1, human respiratory syncytial virus (HRSV, bovine herpesvirus type 2 (BoHV-2, and bovine viral diarrhoea virus (BVDV, respectively. The human rotavirus (RV and BoHV-1 and 5 were not inhibited by the essential oil. Carvacrol alone exhibited high antiviral activity against RV with a SI of 33, but it was less efficient than the oil for the other viruses. Thus, Mexican oregano oil and its main component, carvacrol, are able to inhibit different human and animal viruses in vitro. Specifically, the antiviral effects of Mexican oregano oil on ACVR-HHV-1 and HRSV and of carvacrol on RV justify more detailed studies.

  9. Co-occurrence of Photochemical and Microbiological Transformation Processes in Open-Water Unit Process Wetlands.

    Prasse, Carsten; Wenk, Jannis; Jasper, Justin T; Ternes, Thomas A; Sedlak, David L

    2015-12-15

    The fate of anthropogenic trace organic contaminants in surface waters can be complex due to the occurrence of multiple parallel and consecutive transformation processes. In this study, the removal of five antiviral drugs (abacavir, acyclovir, emtricitabine, lamivudine and zidovudine) via both bio- and phototransformation processes, was investigated in laboratory microcosm experiments simulating an open-water unit process wetland receiving municipal wastewater effluent. Phototransformation was the main removal mechanism for abacavir, zidovudine, and emtricitabine, with half-lives (t1/2,photo) in wetland water of 1.6, 7.6, and 25 h, respectively. In contrast, removal of acyclovir and lamivudine was mainly attributable to slower microbial processes (t1/2,bio = 74 and 120 h, respectively). Identification of transformation products revealed that bio- and phototransformation reactions took place at different moieties. For abacavir and zidovudine, rapid transformation was attributable to high reactivity of the cyclopropylamine and azido moieties, respectively. Despite substantial differences in kinetics of different antiviral drugs, biotransformation reactions mainly involved oxidation of hydroxyl groups to the corresponding carboxylic acids. Phototransformation rates of parent antiviral drugs and their biotransformation products were similar, indicating that prior exposure to microorganisms (e.g., in a wastewater treatment plant or a vegetated wetland) would not affect the rate of transformation of the part of the molecule susceptible to phototransformation. However, phototransformation strongly affected the rates of biotransformation of the hydroxyl groups, which in some cases resulted in greater persistence of phototransformation products. PMID:26562588

  10. Bilateral acute retinal necrosis after herpetic meningitis

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  11. Viral lesions of the mouth in HIV-infected patients.

    Itin, P H; Lautenschlager, S

    1997-01-01

    Viral lesions of the mouth in patients with HIV infection are common and these diseases any be a marker for HIV and disease progression. We review the spectrum of oral viral manifestations and discuss treatment modalities. The most common Epstein-Barr virus (EBV)-induced disorder in HIV-infected patients is oral hairy leukoplakia. EBV-related oral B-cell and T-cell lymphoma in AIDS patients has been described repeatedly. Herpes virus type 1 and rarely type 2 may lead to painful and resistant oral ulcers, and systemic treatment with acyclovir, valaciclovir or famciclovir is indicated. In acyclovir-resistant cases foscarnet is the treatment of choice. In recent years it has been documented that Kaposi's sarcoma, which often affects oral mucosa, is probably induced by herpesvirus type 8. Cytomegalovirus was found in 53% of cases with herpesviridae-induced mucosal ulcers as the only ulcerogenic viral agent in AIDS patients. In severe cytomegalovirus infection treatment with ganciclovir is helpful. Viral warts induced by different HPV may occur in the mouth. Several physical treatment modalities are possible in the oral mucosa. In AIDS patients mollusca contagiosa may occur as large and atypical lesions in the face and lips and rarely in the oral cavity. Cryotherapy is a bloodless treatment in such patients. PMID:9031782

  12. An unusual presentation of herpes simplex encephalitis with negative PCR.

    Buerger, Kelly J; Zerr, Kayleigh; Salazar, Richard

    2015-01-01

    A 74-year-old man presented with acute right-sided hemiparesis and epilepsia partialis continua in association with fever and confusion. Initial workup revealed possible cerebritis in the left medial frontal lobe without involvement of the temporal lobes. Cerebrospinal fluid (CSF) analysis revealed minimal lymphocytic pleocytosis but negative real-time herpes simplex virus (HSV) PCR. Acyclovir was discontinued on day 5 due to a negative infectious workup and clinical improvement. On day 9 his condition deteriorated and he was transferred to a higher level of acuity for advanced supportive care. Worsening encephalopathy and refractory status epilepticus ensued despite medical care. Repeat CSF analysis showed mild lymphocytic pleocytosis with negative real-time HSV PCR. Brain MRI revealed progression of cortical enhancement. Immunosuppressive therapy and plasma exchange were attempted without clinical response. On day 24, another lumbar puncture showed only mild lymphocytic pleocytosis. Brain MRI showed involvement of the right medial temporal lobe. Subsequently, acyclovir was resumed. The HSV-1 PCR result was positive on day 30. Unfortunately, the patient expired. PMID:26243746

  13. Herpes zoster oticus: A rare clinical entity

    Shailesh Gondivkar

    2010-01-01

    Full Text Available Herpes zoster oticus also known as Ramsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion causes otalgia, auricular vesicles, and peripheral facial paralysis. Ramsay Hunt syndrome is rare in children and affects both sexes equally. Incidence and clinical severity increases when host immunity is compromised. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. Although secondary to Bell′s palsy in terms of the cause of acute atraumatic peripheral facial paralysis, Ramsay Hunt syndrome, with incidence ranged from 0.3 to 18%, has a worse prognosis. Herpes zoster oticus accounts for about 12% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. The most advisable method to treat Ramsay Hunt syndrome is the combination therapy with acyclovir and prednisone but still not promising, and several prerequisites are required for better results. We present a case of 32-year-old man suffering from Ramsay Hunt syndrome with grade V facial palsy treated effectively with rehabilitation program, after the termination of the combination therapy of acyclovir and prednisone.

  14. Bilateral Ramsay Hunt syndrome in a diabetic patient

    Goyal Amit

    2004-12-01

    Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

  15. 中西医治疗水痘的临床观察

    刘祥波

    2012-01-01

      目的:观察阿昔洛韦与蓝芩口服液联合用药治疗水痘的临床疗效.方法:47例患者随机分成两组,A 组给予阿昔洛韦与蓝芩口服液,B 组给予阿昔洛韦注射液,比较其疗效和疗程,并进行统计学分析.结果:A 组患儿23例,痊愈为10例,有效为7例,有效率为73.91%;B 组患儿24例,痊愈为14例,有效为10例,有效率为100%.从疗效和疗程来看,A 的治疗方法明显优于 B 组.结论:采用中西医结合的方法治疗水痘能够取得较好的治疗效果,值得临床推广.%  Objective: To observe the clinical efficacy of treating chickenpox with acyclovir plus Lanqin oral liquid. Methods: 47 cases patients were randomly divided into two groups, the group A was gaven acyclovir plus Lanqin oral liquid for treatment, and the group B was treated with acyclovir injection respectively. Compare their efficacy and the course of treatment, and were statistically analyzed. Results: The group A had 23 cases, recovery in 10 cases, effective in 7 cases, the total effective 73.91% ; and the group B had 24 cases, recovery in 14 cases, effective in 10 cases, the total effective 100%. The group A was better than the group B from the curative effect and the treatment. Conclusion: Treating chickenpox in the integrative medicine can get better treatment effect, worthy of clinical promotion.

  16. Selective enhancement of radiation response of herpes simplex virus thymidine kinase transduced 9L gliosarcoma cells in vitro and in vivo by antiviral agents

    Purpose: To demonstrate in a well-characterized tumor model that the radiosensitivity of tumor cells transduced with a herpes simplex virus thymidine kinase gene (HS-tk) would be selectively enhanced by antiviral agents. Methods and Materials: Rat 9L gliosarcoma cells transduced with a retroviral vector containing an HS-tk gene, 9L-tk cells were exposed to various doses of irradiation under either in vitro or in vivo conditions. The radiation sensitizing potential of two antiviral drugs, bromovinyl deoxyuridine (BVdU) and dihydroxymethyl ethyl methyl guanine (acyclovir), was evaluated in vitro. The radiosensitizing ability of BVdU was also evaluated with a 9L-tk tumor growing in the rat brain. Tumors growing in the right hemisphere of rat brains were irradiated stereotactically with single-dose irradiation. Results: The radiation response of 9L-tk cells was selectively enhanced by antiviral agents relative to nontransduced cells. In the cell culture, when a 24-h drug exposure (20 μg/ml) preceded radiation, the sensitizer enhancement ratio (SER) for BVdU and acyclovir was 1.4 ± 0.1 and 1.3 ± 0.1, respectively. Exposure of cells to 10 μg/ml acyclovir for two 24-h periods both pre- and postirradiation resulted in a SER of 1.6 ± 0.1. In vivo, a significant increase in median survival time of rats with 9L-tk tumors was found when BVdU was administered prior to single-dose irradiation relative to the survival time of similar rats receiving radiation alone. Conclusion: An antiviral agent can enhance cell killing by radiation with selective action in cells transduced with the herpes simplex virus thymidine kinase gene. The results suggest that the three-pronged therapy of HS-tk gene transduction, systemically administered antiviral drug, and stereotactically targeted radiation therapy will improve the effectiveness of radiation therapy for the treatment of radioresistant tumors

  17. Selective enhancement of radiation response of herpes simplex virus thymidine kinase transduced 9L gliosarcoma cells in vitro and in vivo by antiviral agents

    The purpose of this investigation was to demonstrate in a well-characterized tumor model that the radiosensitivity of tumor cells transduced with a herpes simplex virus thymidine kinase gene (HS-tk) would be selectively enhanced by antiviral agents. Rat 9L gliosarcoma cells transduced with a retroviral vector containing an HS-tk gene, 9L-tk cells were exposed to various doses or irradiation under either in vitro or in vivo conditions. The radiation sensitizing potential of two antiviral drugs, bromovinyl deoxyuridine (BVdU) and dihydroxymethyl ethyl methyl guanine (acyclovir), was evaluated in vitro. The radiosensitizing ability of BVdU was also evaluated with a 9L-tk tumor growing in the rat brain. Tumors growing in the right hemisphere of rat brains were irradiated stereotactically with single-dose irradiation. The radiation response of 9L-tk cells was selectively enhanced by antiviral agents relative to nontransduced cells. In the cell culture, when a 24-h drug exposure (20 μg/ml) preceded radiation, the sensitizer enhancement ratio (SER) for BVdU and acyclovir was 1.4 ± 0.1 and 1.3 ± 0.1, respectively. Exposure of cells to 10 μg/ml acyclovir for two 24-h periods both pre- and postirradiation resulted in a SER of 1.6 ± 0.1. In vivo, a significant increase in median survival time of rats with 9L-tk tumors was found when BVdU was administered prior to single-dose irradiation relative to the survival time of similar rats receiving radiation alone. An antiviral agent can enhance cell killing by radiation with selective action in cells transduced with the herpes simplex virus thymidine kinase gene. The results suggest that the three-pronged therapy of HS-tk gene transduction, systemically administered antiviral drug, and stereotactically targeted radiation therapy will improve the effectiveness of radiation therapy for the treatment of radioresistant tumors. 25 refs., 6 figs

  18. Effects of solubilizing surfactants and loading of antiviral, antimicrobial, and antifungal drugs on their release rates from ethylene vinyl acetate copolymer

    Tallury, Padmavathy; Randall, Marcus K; Thaw, Khin L; Preisser, John S.; Kalachandra, Sid

    2013-01-01

    Objectives This study investigates the effects of surfactants and drug loading on the drug release rate from ethylene vinyl acetate (EVA) copolymer. The release rate of nystatin from EVA was studied with addition of non-ionic surfactants Tween 60 and Cremophor RH 40. In addition, the effect of increasing drug load on the release rates of nystatin, chlorhexidine diacetate and acyclovir is also presented. Method Polymer casting solutions were prepared by stirring EVA copolymer and nystatin (2.5 wt %) in dichloromethane. Nystatin and surfactants were added in ratios of (1:1), (1:2) and (1:3). Drug loading was studied with 2.5, 5.0, 7.5, and 10.0% wt. proportions of nystatin, chlorhexidine diacetate and acyclovir incorporated into a separate polymer. Three drug loaded polymer square films (3cm × 3cm × 0.08 cm) were cut from dry films to follow the kinetics of drug release at 37°C. 10 ml of either distilled water or PBS was used as the extracting medium that was replaced daily. PBS was used for nystatin release with addition of surfactants and water was used for the study on drug loading and surfactant release. The rate of drug release was measured by UV-spectrophotometer. The amount of surfactant released was determined by HPLC. Results The release of nystatin was low in PBS and its release rate increased with the addition of surfactants. Also, increasing surfactant concentrations resulted in increased drug release rates. The release rates of chlorhexidine diacetate (p<0.0001), acyclovir (p<0.0003) and nystatin (p<0.0017) linearly increased with increasing drug loads. The amount of surfactants released was above the CMC. Significance This study demonstrates that the three therapeutic agents show a sustained rate of drug release from EVA copolymer over extended periods of time. Nystatin release in PBS is low owing to its poor solubility. Its release rate is enhanced by addition of surfactants and increasing the drug load as well. PMID:17049593

  19. Primoinfección por virus del herpes simp le tipo 1. Manejo farmacológico y caracteristicas clínicas

    Hernan Francisco Sariego Santana

    2013-10-01

    Full Text Available ResumenEl presente artículo reporta un caso clínico de gingivoestomatitis herpética primaria y una breve revisión de los medicamentos usados para tratar la infección por virus del herpes simple (HSV. Se presenta un paciente con múltiples ulceraciones confluentes tanto en la cara ventral como en la dorsal de la lengua y en los labios, compatible con gingivoestomatitis herpética primaria. Esta forma de presentarse las ulceraciones y la edad del paciente son frecuentes en pacientes VIH positivo (Virus de la inmunodeficiencia humana, esto no pudo ser comprobado en el caso ya que el paciente dejo de asistir a consulta luego de recibido el tratamiento. El tratamiento instaurado fue aciclovir tabletas 200 mg cada 6 horas vía oral por 10 días. Cabe mencionar que los tratamientos para el virus del herpes simple con aciclovir no están aprobados por la Administración de Alimentos y Drogas de los Estados Unidos (FDA siglas en inglés pero si son aceptados por el Centro de Control de Enfermedades (CDC siglas en ingles, también se utilizó gel de polivinilpirrolidona, hialuronato de sodio para facilitar la deglución del paciente. (DUAZARY 2011 No. 2, 199 - 205AbstractThis article reports a case of primary herpetic gingivostomatitis and a brief review of drugs used to treat infection with herpes simplex virus (HSV. We present a patient with multiple confluent ulcers in both the ventral and the dorsal tongue and lips, compatible with primary herpetic gingivostomatitis. This way of presenting ulceration and patient age are common in HIV positive patients (human immunodeficiency virus, this could not be found in the case because the patient stopped coming to see after the treatment. Acyclovir treatment was introduced 200 mg tablets orally every 6 hours for 10 days. It is noteworthy that the treatments for herpes simplex virus with acyclovir are not approved by the Food and Drug Administration (FDA but if accepted by the Center for Disease Control

  20. Elimination of micropollutants and transformation products from a wastewater treatment plant effluent through pilot scale ozonation followed by various activated carbon and biological filters.

    Knopp, Gregor; Prasse, Carsten; Ternes, Thomas A; Cornel, Peter

    2016-09-01

    Conventional wastewater treatment plants are ineffective in removing a broad range of micropollutants, resulting in the release of these compounds into the aquatic environment, including natural drinking water resources. Ozonation is a suitable treatment process for micropollutant removal, although, currently, little is known about the formation, behavior, and removal of transformation products (TP) formed during ozonation. We investigated the elimination of 30 selected micropollutants (pharmaceuticals, X-ray contrast media, industrial chemicals, and TP) by biological treatment coupled with ozonation and, subsequently, in parallel with two biological filters (BF) or granular activated carbon (GAC) filters. The selected micropollutants were removed to very different extents during the conventional biological wastewater treatment process. Ozonation (specific ozone consumption: 0.87 ± 0.29 gO3 gDOC(-1), hydraulic retention time: 17 ± 3 min) eliminated a large number of the investigated micropollutants. Although 11 micropollutants could still be detected after ozonation, most of these were eliminated in subsequent GAC filtration at bed volumes (BV) of approximately 25,000 m(3) m(-3). In contrast, no additional removal of micropollutants was achieved in the BF. Ozonation of the analgesic tramadol led to the formation of tramadol-N-oxide that is effectively eliminated by GAC filters, but not by BF. For the antiviral drug acyclovir, the formation of carboxy-acyclovir was observed during activated sludge treatment, with an average concentration of 3.4 ± 1.4 μg L(-1) detected in effluent samples. Subsequent ozonation resulted in the complete elimination of carboxy-acyclovir and led to the formation of N-(4-carbamoyl-2-imino-5-oxo imidazolidin)-formamido-N-methoxyacetetic acid (COFA; average concentration: 2.6 ± 1.0 μg L(-1)). Neither the BF nor the GAC filters were able to remove COFA. These results highlight the importance of considering TP in the

  1. Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy

    Ratna B Basak

    2011-01-01

    Full Text Available A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.

  2. Floating microspheres of valacyclovir HCl: Formulation, optimization, characterization, in vitro and in vivo floatability studies

    Nilamgiri Goswami

    2012-01-01

    Full Text Available Floating microspheres are multiple unit Gastroretentive drug delivery systems. Valacyclovir hydrochloride (VCH is L-valyl ester prodrug of acyclovir. VCH degrades in intestinal fluid. The objective was to develop floating microspheres of VCH to localise the drug at upper part of GIT, for improved absorption. Floating microspheres were prepared by W/O emulsification solvent evaporation method using Ethylcellulose (EC as polymer. Particle size and % EE were 550.021±0.241 μm, 79.88±2.236% respectively. in vitro and in vivo floatability studies confirmed floating behaviour of microspheres. VCH loaded floating microspheres can be a suitable alternative to the conventional formulation, by localizing the drug at upper GIT.

  3. Central nervous system infections caused by varicella-zoster virus.

    Chamizo, Francisco J; Gilarranz, Raúl; Hernández, Melisa; Ramos, Diana; Pena, María José

    2016-08-01

    We carried out a clinical and epidemiological study of adult patients with varicella-zoster virus central nervous system infection diagnosed by PCR in cerebrospinal fluid. Twenty-six patients were included. Twelve (46.2 %) patients were diagnosed with meningitis and fourteen (53.8 %) with meningoencephalitis. Twelve (46.2 %) had cranial nerves involvement (mainly the facial (VII) and vestibulocochlear (VIII) nerves), six (23.1 %) had cerebellar involvement, fourteen (53.8 %) had rash, and four (15.4 %) developed Ramsay Hunt syndrome. Three (11.5 %) patients had sequelae. Length of stay was significantly lower in patients diagnosed with meningitis and treatment with acyclovir was more frequent in patients diagnosed with meningoencephalitis. We believe routine detection of varicella-zoster virus, regardless of the presence of rash, is important because the patient may benefit from a different clinical management. PMID:26769041

  4. Chemical and pharmacological significance of natural guanidines from marine invertebrates.

    Ebada, S S; Proksch, P

    2011-03-01

    Natural Guanidines from marine invertebrates represent a group of bioactive secondary metabolites that revealed prominent pharmacological activities such as antimicrobial, antiproliferative, analgesic, and anti-coagulant properties. Acyclovir (Zovirax(®)), the first guanidine-derived pharmaceutical for the treatment of herpes infections since late 1970s, was synthesized based on a marine arabinosyl nucleoside, spongosine. Recently, ziconotide (Prialt(®)), a synthetic form of the marine-derived peptide (ω-conotoxin MVIIA) comprising a guanidine moiety, has been approved for the treatment of chronic pain. This review surveys over 130 compounds of guanidine-containing secondary metabolites from marine invertebrates with emphasis on their pharmacological significance and structure-activity relationships. PMID:21534931

  5. [Herpes zoster paresis. A review of the literature and case reports].

    Lyngberg, K K; Svensson, B H

    1990-04-23

    The incidence of paresis due to herpes zoster (HZ) infections are reported very differently in the literature with rates varying from 0.5 to 31%. Many of the paresis are presumed to be undiagnosed on account of topographic dissociation, variable periods from the cutaneous affection to the muscular involvement, masking of the paresis by pain, paresis of the intercostal and abdominal muscles which are not obvious and difficulties in correlating the visceral symptoms with a herpes zoster eruption. Paresis of the cranial nerves are easily diagnosed and 50% of all HZ paresis are diagnosed from this region. Early acyclovir treatment has improved the prognosis. Four cases of hypotonic herpes zoster paresis in immunocompetent persons are described and the diagnostic difficulties are discussed. PMID:2158682

  6. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

    Gulsen Akkoc

    2016-01-01

    Full Text Available Epstein-Barr virus (EBV usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae.

  7. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

    Akkoc, Gulsen; Kadayifci, Eda Kepenekli; Karaaslan, Ayse; Atici, Serkan; Yakut, Nurhayat; Ocal Demir, Sevliya; Soysal, Ahmet; Bakir, Mustafa

    2016-01-01

    Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae. PMID:27213062

  8. [Complicated febrile convulsion vs herpes-encephalitis].

    Millner, M

    1993-01-01

    Since Acyclovir is available a sufficient treatment of herpes simplex virus (HSV) encephalitis exists. Febrile convulsions may occur as the initial manifestation of an encephalitis, particularly of an HSV encephalitis. Within 25 months out of 151 children with febrile convulsions five children with complicated febrile convulsions were admitted at the pediatric department of Graz. In all children HSV antibodies in serum and cerebrospinal fluid (CSF) were negative and the diagnosis of an HSV encephalitis was made by positive CSF HSV polymerase chain reaction (PCR). Therefore, in any suspected case, i.e. in any case of a complicated febrile convulsion, CSF should be investigated including a HSV PCR to rapidly confirm or exclude HSV encephalitis. PMID:8386831

  9. 027.无环鸟苷新型脂质载体制剂治疗复发性疱疹性唇炎的临床评价

    2001-01-01

    @@  [英]/Horwitz E…∥Oral Surg Oral Med Oral Patho1.-1999,87(6).-700~ 705   环鸟苷(acyclovir,ACV)是一种有效的治疗复发性疱疹性唇炎(recurrent herpes labialis,RHL)的药物,与口服药相比,有许多优点.常用剂型有5%、10%ACV软膏和5%ACV霜剂,但临床报道其渗透效果均不理想,影响疗效发挥.本研究目的是评价一种无环鸟苷新型脂质载体ethosome治疗RHL的临床效果.    出版日期:2001年3月20日 请看PDF全文

  10. Perinatal Chicken Pox (Varicella Zoster Virus Infection

    Ali Annagur

    2013-04-01

    Full Text Available Chickenpox is due to infection with the varicella zoster virus (VZV, a human alphaherpervirus found worldwide. Classically, the cinical disease is a febrile illness with a pruritic vesicular rash. Maternal chickenpox between 5 days before delivery to 2 days after delivery (perinatal varicella can cause severe and even fatal illness in the newborn. A 7-day old girl baby presented on day 4 of postnatal with the complaints of widespread vesicular rash and non-suckling. Mother of the baby also had a similar eruption four day prior to delivery, which was clinically characteristic of varicella. Considering history and clinical presentation, a diagnosis of perinatal chickenpox was considered and the baby was treated with acyclovir which she responded and recovered. Herein, the clinical feasures and treatment of chickenpox infection in the perinatal period have been emphasized with this case report. [Cukurova Med J 2013; 38(2.000: 311-314

  11. Supra-recommendation Treatment of Super-refractory Status Epilepticus

    Vyas, Devashish Dhiren; Dash, Gopal Krishna

    2016-01-01

    A 28-year old female was admitted with recurrent seizures following 2 days of febrile illness, after which she developed status epilepticus. Midazolam and later thiopentone infusions were started after failure of regular intravenous antiepileptics. Burst suppression was achieved at doses of 3 mg/kg/hr for midazolam and 6 mg/kg/hr of thiopentone. Adjunctive medications included methylprednisolone, intravenous immunoglobulin and acyclovir. Imaging and biochemical parameters were normal. She required 3 cycles of midazolam and 2 cycles of thiopentone for complete cessation of seizures. She recovered with mild attentional and recent memory deficits on follow up. Treatment of super-refractory status epilepticus requires individualized regimens and may need doses beyond conventional limits. To the best of our knowledge, there is no such reported case from India. PMID:27390680

  12. Herpes Simplex Encephalitis Presenting with Normal CSF Analysis

    A 28 years old female presented with headache, fever, altered sensorium and right side weakness for one week. She was febrile and drowsy with right sided hemiplegia and papilledema. Tuberculous or bacterial meningitis, tuberculoma and abscess were at the top of the diagnosis list followed by Herpes simplex meningo-encephalitis (HSE). MRI showed abnormal signal intensity of left temporal lobe without significant post-contrast enhancement and midline shift. CSF examination was normal, gram stain and Ziehl-Neelsen stain showed no micro-organism, or acid fast bacilli. CSF for MTB PCR was negative. PCR DNA for Herpes simplex 1 on CSF was detected. Acyclovir was started and the patient was discharged after full recovery. A high index of suspicion is required for HSE diagnosis in Pakistan where other infections predominantly affect the brain and HSE may be overlooked as a potential diagnosis. (author)

  13. Herpes simplex virus encephalitis: neuroradiological diagnosis

    Herpes simplex virus encephalitis (HSE) is the most frequent viral encephalitis, as a rule with the starting point and centre within the temporal lobe. If untreated, HSE is usually fatal, thus diagnosis has to be established rapidly. Treatment with Acyclovir should begin as soon possible. As MRI is extremely sensitive in detecting the early inflammatory changes, it should be initially performed, especially as in the early stadium CT may be unspecific. We recommend the following examination protocol: coronar T1-weighted MR imaging before and after administration of gadopentetate dimeglumine, coronar FLAIR sequence and axial T2-weighted imaging. The diagnostic proof is to show the evidence of viral DNA by polymerase chain reaction (PCR) in cerebrospinal liquor. (orig.)

  14. Antibacterial, antifungal, and antiviral activities of the lipophylic extracts of Pistacia vera.

    Ozçelik, Berrin; Aslan, Mustafa; Orhan, Ilkay; Karaoglu, Taner

    2005-01-01

    In the present study, antibacterial, antifungal, and antiviral properties of 15 lipohylic extracts obtained from different parts (leaf, branch, stem, kernel, shell skins, seeds) of Pistacia vera were screened against both standard and the isolated strains of Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus, Candida albicans and C. parapsilosis by microdilution method. Both Herpes simplex (DNA) and Parainfluenza viruses (RNA) were used for the determination of antiviral activity of the P. vera extracts by using Vero cell line. Ampicilline, ofloxocine, ketoconazole, fluconazole, acyclovir and oseltamivir were used as the control agents. The extracts showed little antibacterial activity between the range of 128-256 microg/ml concentrations whereas they had noticeable antifungal activity at the same concentrations. Kernel and seed extracts showed significant antiviral activity compared to the rest of the extracts as well as the controls. PMID:15881833

  15. Herpes simplex virus infection in burned patients: epidemiology of 11 cases.

    Bourdarias, B; Perro, G; Cutillas, M; Castede, J C; Lafon, M E; Sanchez, R

    1996-06-01

    Burned patients suffer significant immunosuppression during the first 3 or 4 weeks after hospitalization. Herpes simplex virus (HSV) infections are commonly seen in immunosuppressed patients and may account for considerable morbidity and some mortality. We studied retrospectively 11 patients with severe burn injury who became infected with HSV. We determined the prevalence of viral infection in this group of patients. Serological testing and viral culture was used to diagnose HSV infection. No general complications appeared in these 11 patients in association with HSV but two patients died of multiorgan failure. Locally, areas of active epidermal regeneration were most commonly affected. Acyclovir therapy was not used and the duration of hospitalization was normal in these 11 patients. PMID:8781721

  16. A rare case of ulcerative colitis exacerbated by VZV infection.

    Nishimura, Satoshi; Yoshino, Takuya; Fujikawa, Yoshiki; Watanabe, Masaki; Yazumi, Shujiro

    2015-12-01

    A 16-years old man with severe ulcerative colitis (UC) was admitted to our hospital. After initiating treatment with corticosteroid for UC, chicken pox appeared. At the same time of appearance of chicken pox, the disease activity of UC was exacerbated. After initiating the treatment with acyclovir, both chicken pox and UC improved. Because colonoscopic findings revealed the remaining of moderately active UC, initiating the treatment with infliximab could induce clinical remission of UC without relapse of varicella-zoster virus (VZV) infection. This is a very rare case of UC with concomitant VZV infection. According to our report, the vaccination for VZV prior to immunosuppressive treatments would be necessary for VZV naïve patients with UC. PMID:26552918

  17. Periorbital varicella gangrenosa: A rare complication of chicken pox

    Jagriti Jain

    2015-01-01

    Full Text Available A previously healthy six year old male child presented in pediatrics ICU in state of shock with history of fever and rashes and later was diagnosed as chicken pox. He developed right sided periorbital varicella gangrenosa which is a form of necrotizing fasciitis secondary to skin infection. Patient was treated with intravenous acyclovir, antibiotics, amphotericin B, extensive debridement and later reconstruction of upper eyelid with skin grafting. Aggressive treatment helped preventing the eyeball and orbital involvement which would have necessitated orbital exenteration. However delayed presentation resulted in necrosis of orbicularis oculi and underlying tissue which resulted in graft retraction and lid dysfunction. Clinicians should be aware of this rare but fulminating condition to minimise the sight and life threatening complications associated with it.

  18. Periorbital varicella gangrenosa: A rare complication of chicken pox.

    Jain, Jagriti; Thatte, Shreya; Singhai, Prakhar

    2015-01-01

    A previously healthy six year old male child presented in pediatrics ICU in state of shock with history of fever and rashes and later was diagnosed as chicken pox. He developed right sided periorbital varicella gangrenosa which is a form of necrotizing fasciitis secondary to skin infection. Patient was treated with intravenous acyclovir, antibiotics, amphotericin B, extensive debridement and later reconstruction of upper eyelid with skin grafting. Aggressive treatment helped preventing the eyeball and orbital involvement which would have necessitated orbital exenteration. However delayed presentation resulted in necrosis of orbicularis oculi and underlying tissue which resulted in graft retraction and lid dysfunction. Clinicians should be aware of this rare but fulminating condition to minimise the sight and life threatening complications associated with it. PMID:25709281

  19. Varicella Pneumonia in a 39-year-old Female in Third Trimester Twin Pregnancy

    Baljic, Rusmir; Hadzovic, Meliha; Mehanic, Snjezana; Lukovac, Enra; Koluder-Cimic, Nada; Baljic, Izet; Imsirovic, Bilal

    2012-01-01

    SUMMARY CONFLICT OF INTEREST: none declared. Introduction Chickenpox is disease caused by varicella-zoster virus (VZV), with possibly devastated consequences during pregnancy, for mother and neonate. Pneumonia is most common complication in pregnancy with very high mortality. Case report A 39-year-old female in third trimester twin pregnancy, referred to Clinic for infectious diseases in Sarajevo, with five days history of illness. Before the admission her condition get worse, with fatigue, exhaustion, and shortness of breath. In a first three days patient was febrile, tachydispnoic and ortopnoic. We started therapy with acyclovir and antibiotic. After four days we had detoriation in patient’s condition. Chest X-ray revealed infiltrative shadows in basal parts of lung. Antimicrobial therapy was changed and corticosteroids were associated. Significant improvement was noticed after five days of therapy. Conclusion Varicella pneumonia during third trimester may have serious consequences for mother and child, with possible fatal outcome. PMID:24493990

  20. Pediatric Ramsay Hunt Syndrome: Analysis of Three Cases

    İmran Aydoğdu

    2015-01-01

    Full Text Available Ramsay Hunt syndrome (RHS is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction and is attributed to varicella zoster virus (VZV infection in the geniculate ganglion. Although it is a common cause of acute peripheral facial paralysis, children are not usually affected. The diagnosis is based on history and physical findings. Treatment of RHS uses a combination of high-dose corticosteroids and acyclovir. This paper presents three cases diagnosed as RHS in the pediatric age group in association with the literature review. The aim of this paper is to emphasize the importance of careful examination and early initiation of therapy in suspected cases of RHS.

  1. In vivo PET imaging with {sup 18}F-FHBG of hepatoma cancer gene therapy using herpes simplex virus thymidine kinase and ganciclovir

    Lee, TaeSup; Kim, JunYoup; Moon, ByungSeok; Kang, JooHyun; Song, Inho; Kwon, HeeChung; Kim, KyungMin; Cheon, GiJeong; Choi, ChangWoon; Lim, SangMoo [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2007-07-01

    Monitoring gene expression in vivo to evaluate the gene therapy efficacy is a critical issue for scientists and physicians. Non-invasive nuclear imaging can offer information regarding the level of gene expression and its location when an appropriate reporter gene is constructed in the therapeutic gene therapy. Herpes simplex virus type 1 thymidine kinase gene (HSV1-tk) is the most common reporter gene and is used in cancer gene therapy by activating relatively nontoxic compounds, such as acyclovir or ganciclovir (GCV), to induce cell death. In this study, we investigate the feasibility of monitoring cancer gene therapy using retroviral vector transduced HSV1-tk and GCV, in vitro cellular uptake and in vivo animal studies, including biodistribution and small animal positron emission tomography (PET) imaging, were performed in HSV1-tk and luciferase (Luc)-transduced MCA-TK/Luc and enhanced green fluorescent protein (eGFP)-transduced MCA-eGFP hepatoma cell lines.

  2. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis.

    Akkoc, Gulsen; Kadayifci, Eda Kepenekli; Karaaslan, Ayse; Atici, Serkan; Yakut, Nurhayat; Ocal Demir, Sevliya; Soysal, Ahmet; Bakir, Mustafa

    2016-01-01

    Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae. PMID:27213062

  3. A case of atypical progressive outer retinal necrosis after highly active antiretroviral therapy.

    Woo, Se Joon; Yu, Hyeong Gon; Chung, Hum

    2004-06-01

    This is a report of an atypical case of progressive outer retinal necrosis (PORN) and the effect of highly active antiretroviral therapy (HAART) on the clinical course of viral retinitis in an acquired immunodeficiency syndrome (AIDS) patient. A 22-year-old male patient infected with human immunodeficiency virus (HIV) presented with unilaterally reduced visual acuity and a dense cataract. After cataract extraction, retinal lesions involving the peripheral and macular areas were found with perivascular sparing and the mud-cracked, characteristic appearance of PORN. He was diagnosed as having PORN based on clinical features and was given combined antiviral treatment. With concurrent HAART, the retinal lesions regressed, with the regression being accelerated by further treatment with intravenous acyclovir and ganciclovir. This case suggests that HAART may change the clinical course of PORN in AIDS patients by improving host immunity. PORN should be included in the differential diagnosis of acute unilateral cataract in AIDS patients. PMID:15255240

  4. Localized Eruptive Blue Nevi after Herpes Zoster

    Colson, Fany; Arrese, Jorge E.; Nikkels, Arjen F.

    2016-01-01

    A 52-year-old White man presented with a dozen small, well-restricted, punctiform, asymptomatic, blue-gray macules on the left shoulder. A few months earlier, he had been treated with oral acyclovir for herpes zoster (HZ) affecting the left C7–C8 dermatomes. All the blue macules appeared over a short period of time and then remained stable. The patient had not experienced any previous trauma or had tattooing in this anatomical region. The clinical diagnosis suggested blue nevi. Dermatoscopy revealed small, well-limited, dark-blue, compact, homogeneous areas evoking dermal blue nevi. An excisional biopsy was performed and the histological examination confirmed a blue nevus. As far as we are aware of, this is the first report of eruptive blue nevi following HZ, and it should be included in the differential diagnosis of zosteriform dermatoses responding to an isotopic pathway. In addition, a brief review concerning eruptive nevi is presented. PMID:27462219

  5. Structure and function of multidrug and toxin extrusion proteins (MATEs) and their relevance to drug therapy and personalized medicine.

    Nies, Anne T; Damme, Katja; Kruck, Stephan; Schaeffeler, Elke; Schwab, Matthias

    2016-07-01

    Multidrug and toxin extrusion (MATE; SLC47A) proteins are membrane transporters mediating the excretion of organic cations and zwitterions into bile and urine and thereby contributing to the hepatic and renal elimination of many xenobiotics. Transported substrates include creatinine as endogenous substrate, the vitamin thiamine and a number of drug agents with in part chemically different structures such as the antidiabetic metformin, the antiviral agents acyclovir and ganciclovir as well as the antibiotics cephalexin and cephradine. This review summarizes current knowledge on the structural and molecular features of human MATE transporters including data on expression and localization in different tissues, important aspects on regulation and their functional role in drug transport. The role of genetic variation of MATE proteins for drug pharmacokinetics and drug response will be discussed with consequences for personalized medicine. PMID:27165417

  6. [Efficacy of plant products against herpetic infections].

    Schnitzler, P; Reichling, J

    2011-12-01

    Essential oils from various aromatic medicinal plants are highly active against some viral infections, e.g. labial herpes caused by herpes simplex virus type 1. Balm oil, tea tree oil and peppermint oil demonstrate in vitro a significant antiherpetic activity, mainly related to a direct drug-virus particle interaction, some essential oils also act directly virucidal. Interestingly, these essential oils are also highly active against acyclovir-resistant herpes simplex virus strains. In clinical studies, tea tree oil has been shown to possess antiherpetic, anti-inflammatory and pain-relieving properties, as well as to accelerate the healing process of herpes labialis. Applying diluted essential oils three to four times daily for the antiherpetic treatment of affected areas is recommended. Some companies have marketed plant products, e.g. from Melissa, for the treatment of recurrent herpetic infections. PMID:21607799

  7. Herpes Simplex Virus Sepsis in a Young Woman with Crohn's Disease.

    Haag, Lea-Maxie; Hofmann, Jörg; Kredel, Lea Isabell; Holzem, Christina; Kühl, Anja A; Taube, Eliane T; Schubert, Stefan; Siegmund, Britta; Epple, Hans-Jörg

    2015-12-01

    We present the case of a herpes simplex virus-1 [HSV-1] sepsis with severe herpes hepatitis in a young female treated with triple immunosuppressive therapy [adalimumab, azathioprine, prednisolone] for refractory Crohn's disease [CD]. The patient presented with high fever, generalised abdominal tenderness, strongly elevated transaminases, coagulopathy, and pancytopenia. Comprehensive diagnostics including blood HSV-1 polymerase chain reaction [PCR], liver biopsy, and immunohistochemistry revealed the diagnosis of fulminant herpes hepatitis. HSV-1 positivity of cutaneous lesions proved the disseminated nature of the infection. Early treatment with intravenous acyclovir led to a rapid improvement of the patient's condition and resulted in a full recovery of her liver function. This is the first reported case of HSV-sepsis in a patient with CD. Physicians treating inflammatory bowel disease [IBD] patients with combined immunosuppressive therapy should be aware of the possibility of herpes hepatitis, and early empirical antiviral therapy should be considered in immunosuppressed patients presenting with fever and severe anicteric hepatitis. PMID:26351382

  8. Superior orbital fissure syndrome in herpes zoster ophthalmicus.

    Kirwan, R P

    2012-02-01

    AIM: To report a case of superior orbital fissure syndrome (SOFS) in a patient with herpes zoster ophthalmicus (HZO). MATERIALS AND METHODS: A case report. RESULTS: A 71-year-old male with HZO presented acutely to accident and emergency complaining of right vision loss, double vision and drowsiness. The right visual acuity was counting fingers. There was no relative afferent pupillary defect. He had interstitial keratitis, ptosis, proptosis and total ophthalmoplaegia. The signs indicated HZO complicated by SOFS. Brain imaging and lumbar puncture confirmed the diagnosis of varicella zoster encephalitis. Systemic acyclovir and prednisolone led to recovery of visual acuity and ocular motility in addition to resolution of his proptosis and ptosis. CONCLUSION: SOFS is a rare complication of herpes zoster infection. With the appropriate treatment and follow-up, patients may be reassured that recovery of their visual acuity and ocular motility will occur.

  9. [Separation of bases, phenols and pharmaceuticals on ionic liquid-modified silica stationary phase with pure water as mobile phase].

    Wang, Xusheng; Qiu, Hongdeng; Liu, Xia; Jiang, Shengxiang

    2011-03-01

    N-methylimidazolium ionic liquid (IL) -modified silica was prepared with the reaction of 3-chloropropyl modified silica and N-methylimidazole using toluene as solvent. Based on the multiple interactions between N-methylimidazolium IL-modified silica and analytes such as hydrophobic interaction, electrostatic attraction, repulsion interaction, hydrogen-bonding, etc., the bases (cytosine, thymine, 2-aminopyrimidine and 6-chloroguanine), phenols (m-aminophenol, resorcinol and m-nitrophenol) and three pharmaceuticals (moroxydine hydrochloride, acyclovir and cephalexin hydrate) were separated successfully with only pure water as the mobile phase. These chromatographic separations are environmental friendly, economical and convenient, without any organic solvent or buffer additive. The retention mechanism of these samples on the stationary phase was also investigated. PMID:21657060

  10. Skin infections in pregnancy.

    Müllegger, Robert R; Häring, Nina S; Glatz, Martin

    2016-01-01

    A wide array of infectious diseases can occur in pregnancy. Their acquisition, clinical presentation, and course during gestation may be altered due to an impairment of the maternal cellular immunity. Some infectious diseases can lead to serious consequences for the mother or the offspring, including congenital malformations. This review describes in detail the clinical presentation, course, management, and associated maternal and fetal risks of selected viral (varicella-zoster virus infections, condylomata acuminata), fungal (candida vulvovaginitis), bacterial (Lyme borreliosis), and parasitic (scabies) infections. The treatment options are critically reviewed. First-line therapies include acyclovir and varicella-zoster virus immunoglobulin for varicella-zoster virus infections, surgical modalities for genital warts, topical clotrimazole and oral fluconazole for Candida vulvovaginitis, amoxicillin and cefuroxime for Lyme borreliosis, and permethrin for scabies. A synopsis of maternal and fetal risks of other important infections is also included. PMID:27265075

  11. The clinical analysis of radical total gastrectomy and jejunal interposition on behalf of the stomach surgery in the treatment of 37 patients with gastric cancer%根治性全胃切除空肠间置代胃术治疗37例胃癌患者临床作用分析

    阮戈; 谈凯

    2012-01-01

    目的 探索运用根治性全胃切除空肠间置代胃术治疗胃癌的临床疗效.方法 研究选取37例于某院进行诊治胃癌患者,全部予以根治性全胃切除空肠间置代胃术进行消化道的治疗和重建,并于手术后1年内进行术后并发症、营养状况及复查结果等方面的持续随访.结果 全部患者术后生存期均超过1年以上,有3例患者术后出现进食后伴有轻度胸骨后疼痛感,其余患者均未出现吞咽困难、胸骨后烧灼感及食物反流等表现;全部患者术后体重均较前增加,胃镜检查显示均未出现吻合口炎症或胆汁反流征,血生化检查中的血红蛋白、白蛋白及总蛋白量均恢复至正常范围内.结论 在全胃切除后实施连续空肠间置术对消化道进行重建,可在最大限度清除癌变病灶的同对,尽可能的保留胃肠道的生理功能,从而尽量减少术后食管反流等并发症的发生并提高患者的术后营养状况.而且该手术方法污染较少,肠管自愈能力较强,吻合口瘘发生率较低.另外,该手术操作吻合口较少,加之吻合传的临床应用,使得吻合操作的步骤较为简便可靠,手术时间也大大减少,十分适宜临床的广泛应用及普及.%OBJECTIVE To evaluate the efficacy of oral acyclovir in treatment of chickenpox. METHODS Updated evidences were identified by searching Cochrane library, MEDUNE and EMBASE. Only systematic reviews, randomized controlled trials (RCTs) and quasi- RCTs were included. The efficacy of oral acyclovir in treatment of chickenpox in healthy children was analyzed through evidence-based methods. RESULTS Oral acyclovir was associated with the reductions in the number of days with fever and in the number of rash. There were less supportive evidences in shortening the number of days to get new rash and relieving pruritus. CONCLUSION The clinical importance of oral acyclovir treatment in healthy children remains uncertain.

  12. In vivo PET imaging with 18F-FHBG of hepatoma cancer gene therapy using herpes simplex virus thymidine kinase and ganciclovir

    Monitoring gene expression in vivo to evaluate the gene therapy efficacy is a critical issue for scientists and physicians. Non-invasive nuclear imaging can offer information regarding the level of gene expression and its location when an appropriate reporter gene is constructed in the therapeutic gene therapy. Herpes simplex virus type 1 thymidine kinase gene (HSV1-tk) is the most common reporter gene and is used in cancer gene therapy by activating relatively nontoxic compounds, such as acyclovir or ganciclovir (GCV), to induce cell death. In this study, we investigate the feasibility of monitoring cancer gene therapy using retroviral vector transduced HSV1-tk and GCV, in vitro cellular uptake and in vivo animal studies, including biodistribution and small animal positron emission tomography (PET) imaging, were performed in HSV1-tk and luciferase (Luc)-transduced MCA-TK/Luc and enhanced green fluorescent protein (eGFP)-transduced MCA-eGFP hepatoma cell lines

  13. Ultrasound for critical care physicians: neutropenic patient with fever snd shortness of breath

    Kraai E

    2014-06-01

    Full Text Available No abstract available. Article truncated after first page. A 63 year old female with a history of acute myelogenous leukemia presents with shortness of breath, fever and hypotension to the ICU. She is in septic shock on norepinephrine, and has been treated on the oncology unit with vancomycin, cefepime, acyclovir and voriconazole. She has been neutropenic for 1 month. The patient develops a progressive right lower chest opacity. This opacity has progressed in spite of antibiotics and antifungals. The portable AP chest radiograph is presented below (Figure 1. An ultrasound of the right chest was performed for further evaluation of the opacity (figure 2. Question: What pathology does the ultrasound reveal in the right hemithorax? 1. Air filled cavity; 2. Chest wall abscess; 3. Fractured ribs; 4. Pleural effusion and suspected empyema; 5. Simple consolidation ...

  14. Recurrent herpes zoster in a child with SLE

    Jain C

    1995-01-01

    Full Text Available A 12-year-old girl had systemic lupus erythematosus (SLE and type IV lupus nephritis since three-and-a-half years. She was treated with prednisolone and cyclophosphamide. She had first attack of herpes zoster (HZ involving eighth and ninth thoracic segments on right side at the age of nine years. Second attack occurred on the same segments on same side at the age of twelve years. The second attack of herpes zoster was treated with oral acyclovir 400 mg five times a day for seven days plus analgesics and multi-vitamins. Most probably this is the first case of recurrent herpes zoster (RHZ in a child in Indian literature.

  15. Herpes Zoster-Induced Ogilvie's Syndrome

    Masood, Irfan; Majid, Zain; Rind, Waqas; Zia, Aisha; Riaz, Haris; Raza, Sajjad

    2015-01-01

    Ogilvie's syndrome due to herpes zoster infection is a rare manifestation of VZV reactivation. The onset of rash of herpes zoster and the symptoms of intestinal obstruction can occur at different time intervals posing a significant diagnostic challenge resulting in avoidable surgical interventions. Herein, we describe a case of 35-year-old male who presented with 6-day history of constipation and colicky abdominal pain along with an exquisitely tender and vesicular skin eruption involving the T8–T11 dermatome. Abdominal X-ray and ultrasound revealed generalized gaseous distention of the large intestine with air up to the rectum consistent with paralytic ileus. Colonoscopy did not show any obstructing lesion. A diagnosis of Ogilvie's syndrome associated with herpes zoster was made. He was conservatively managed with nasogastric decompression, IV fluids, and acyclovir. The patient had an uneventful recovery and was later discharged. PMID:26664758

  16. Varicella Gangrenosa of Abdominal Wall: Rare but Fatal Complication of Varicella Even in Immunocompetent Healthy Children

    Saini

    2015-11-01

    Full Text Available Introduction Varicella gangrenosa is an uncommon but serious complication of chicken pox in young children. It should be suspected in any child with a history of varicella infection and increasing complaints of pain and swelling in an extremity or other body area, along with increasing fever, erythema, lethargy, and irritability. Early surgical intervention with intensive antibiotic therapy is essential to prevent fatal consequences. Case Presentation We describe a case of a previously healthy child who presented with sepsis due to varicella gangrenosa. While she initially responded well to a conservative antibiotic and acyclovir treatment, her subsequent rapid deterioration required urgent and repeated debridement. Conclusions This report highlights the significance of prompt diagnosis and early surgical intervention for management of varicella gangrenosa.

  17. Ramsay Hunt Syndrome Associated with Central Nervous System Involvement in an Adult.

    Chan, Tommy L H; Cartagena, Ana M; Bombassaro, Anne Marie; Hosseini-Moghaddam, Seyed M

    2016-01-01

    Ramsay Hunt syndrome associated with varicella zoster virus reactivation affecting the central nervous system is rare. We describe a 55-year-old diabetic female who presented with gait ataxia, right peripheral facial palsy, and painful vesicular lesions involving her right ear. Later, she developed dysmetria, fluctuating diplopia, and dysarthria. Varicella zoster virus was detected in the cerebrospinal fluid by polymerase chain reaction. She was diagnosed with Ramsay Hunt syndrome associated with spread to the central nervous system. Her facial palsy completely resolved within 48 hours of treatment with intravenous acyclovir 10 mg/kg every 8 hours. However, cerebellar symptoms did not improve until a tapering course of steroid therapy was initiated. PMID:27366189

  18. Neonatal herpes simplex virus type-1 central nervous system disease with acute retinal necrosis.

    Fong, Choong Yi; Aye, Aye Mya Min; Peyman, Mohammadreza; Nor, Norazlin Kamal; Visvaraja, Subrayan; Tajunisah, Iqbal; Ong, Lai Choo

    2014-04-01

    We report a case of neonatal herpes simplex virus (HSV)-1 central nervous system disease with bilateral acute retinal necrosis (ARN). An infant was presented at 17 days of age with focal seizures. Cerebrospinal fluid polymerase chain reaction was positive for HSV-1 and brain magnetic resonance imaging showed cerebritis. While receiving intravenous acyclovir therapy, the infant developed ARN with vitreous fluid polymerase chain reaction positive for HSV-1 necessitating intravitreal foscarnet therapy. This is the first reported neonatal ARN secondary to HSV-1 and the first ARN case presenting without external ocular or cutaneous signs. Our report highlights that infants with neonatal HSV central nervous system disease should undergo a thorough ophthalmological evaluation to facilitate prompt diagnosis and immediate treatment of this rapidly progressive sight-threatening disease. PMID:24378951

  19. Recovery from CMV esophagitis after allogeneic bone marrow transplantation using non-myeloablative conditioning: the role of immunosuppression.

    Fiegl, Michael; Gerbitz, Armin; Gaeta, Antonia; Campe, Hartmut; Jaeger, Gundula; Kolb, Hans-Jochem

    2005-11-01

    Cytomegalovirus (CMV) positive recipients of CMV negative bone marrow bear a significantly higher risk of developing CMV disease compared to all other constellations. Here, we report a case of severe CMV induced esophagitis after allogeneic bone marrow transplantation for paroxysmal nocturnal hemoglobinuria. The patient developed the first symptoms between day 10 and 20 after dose reduced conditioning and HLA-matched unrelated stem cell transplantation. Esophageal tissue biopsies as well as peripheral blood proved positive for CMV DNA by PCR. Treatment with acyclovir, ganciclovir, foscarnet, cidofovir, and immunoglobulines resulted in elimination of CMV in peripheral blood but not in clinical improvement. Only tapering of cyclosporine at day +120 eventually led to the development of CMV-specific T-cells and resolution of esophagitis. PMID:16129661

  20. New strategies against drug resistance to herpes simplex virus

    Yu-Chen Jiang; Hui Feng; Yu-Chun Lin; Xiu-Rong Guo

    2016-01-01

    Herpes simplex virus (HSV), a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir (ACV) and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets (the DNA helicase/primase (H/P) complex), new types of molecules (nature products) and new antiviral mechanisms (lethal mutagenesis of Janus-type nucleosides) to fight the drug resistance of HSV.

  1. The antiviral drug valacyclovir successfully suppresses salivary gland hypertrophy virus (SGHV in laboratory colonies of Glossina pallidipes.

    Adly M M Abd-Alla

    Full Text Available Many species of tsetse flies are infected with a virus that causes salivary gland hypertrophy (SGH symptoms associated with a reduced fecundity and fertility. A high prevalence of SGH has been correlated with the collapse of two laboratory colonies of Glossina pallidipes and colony maintenance problems in a mass rearing facility in Ethiopia. Mass-production of G. pallidipes is crucial for programs of tsetse control including the sterile insect technique (SIT, and therefore requires a management strategy for this virus. Based on the homology of DNA polymerase between salivary gland hypertrophy virus and herpes viruses at the amino acid level, two antiviral drugs, valacyclovir and acyclovir, classically used against herpes viruses were selected and tested for their toxicity on tsetse flies and their impact on virus replication. While long term per os administration of acyclovir resulted in a significant reduction of productivity of the colonies, no negative effect was observed in colonies fed with valacyclovir-treated blood. Furthermore, treatment of a tsetse colony with valacyclovir for 83 weeks resulted in a significant reduction of viral loads and consequently suppression of SGH symptoms. The combination of initial selection of SGHV-negative flies by non-destructive PCR, a clean feeding system, and valacyclovir treatment resulted in a colony that was free of SGH syndromes in 33 weeks. This is the first report of the use of a drug to control a viral infection in an insect and of the demonstration that valacyclovir can be used to suppress SGH in colonies of G. pallidipes.

  2. Neonatal varicella pneumonia, surfactant replacement therapy

    Mousa Ahmadpour-kacho

    2015-12-01

    Full Text Available Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.

  3. A method for evaluating antiviral drug susceptibility of Epstein-Barr virus

    Charlotte A Romain

    2010-01-01

    Full Text Available Charlotte A Romain1, Henry H Balfour Jr1,2, Heather E Vezina1,3, Carol J Holman11Department of Laboratory Medicine and Pathology, 2Department of Pediatrics, 3Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USAAbstract: We developed an in vitro Epstein-Barr virus (EBV drug susceptibility assay using P3HR1 cells or lymphoblastoid cells from subjects with infectious mononucleosis, which were grown in the presence of various concentrations of acyclovir (ACV, ganciclovir (GCV or R-9-[4-hydroxy-2-(hydroxymethylbutyl]guanine (H2G and 12-O-tetradecanoyl-phorbol-13-acetate (TPA. On day 7, total cellular DNA was extracted and EBV DNA was detected using an in-house quantitative real-time polymerase chain reaction (PCR method. All three drugs had in vitro activity against EBV in both the laboratory standard producer cell line P3HR1 and in subject-derived lymphoblastoid cell lines. The median 50% inhibitory concentrations (IC50s in P3HR1 cells were: ACV, 3.4 μM; GCV, 2.6 μM; and H2G, 2.7 μM and in 3 subject-derived cells were: ACV, 2.5 μM; GCV, 1.7 μM; and H2G, 1.9 μM. Our assay can be used to screen candidate anti-EBV drugs. Because we can measure the IC50 of patients’ strains of EBV, this assay may also be useful for monitoring viral resistance especially in immunocompomised hosts receiving antiviral drugs for prevention or treatment of EBV diseases.Keywords: Epstein-Barr virus, ganciclovir, acyclovir, valomaciclovir, H2G, antivirals

  4. A Study of the Antiviral Effect of the Essential oil of Zataria Multiflora Boiss on Herpes Simplex Type 1 in Vero Cell Culture

    Mardani M.

    2012-02-01

    Full Text Available Statement of Problems: Herpes Simplex type 1 (HSV-1 is associated with different human infections including oral infection. Acyclovir is used for the treatment of such herpetic infections. However, acyclovir resistant HSVs are increasing nowadays due to the lack of thymidine kinase activity in HSV mutants. So, researchon alternative treatment is urgently required. Purpose: The aim of this study was to examine the effect of essential oil of Zataria multiflora Boiss on herpes simplex type 1 in Vero cell culture.Materials and Method: The essence of Zataria multiflora was prepared by the clevenger apparatus and used for the experiments in Vero cell culture. Cytotoxic effect of increasing concentrations of the essence from 0.001-0.02% was assessed on Vero cell line and antiviral effect of the essence was studied in Vero cells, using plaque reduction method. The data were analyzed by one way ANOVA using SPSS, version 17.Results: The 50% cytotoxic concentration (CC50 of Zataria multiflora essential oil for Vero cells and 50% inhibitory concentration (IC50 were 0.067% and 0.0059%, respectively. Compared to the controls, all the above used concentrations had the inhibitory effect on HSV-1 ( p <0.05. Concentrations of 0.1- 0.2% showed a complete anti-HSV-1 inhibitory effect. Conclusion: The results of this study showed that essential oil of Zataria multiflora Boiss has a significant inhibitory effect on HSV-1, so it may be used as an anti-herpetic mouthwash candidate for the control of oral HSV infections. However, in vivo studies might be necessary for determining its exact toxic effects on human cells.

  5. Treatment of sarcoids in equids: 230 cases (2008-2013).

    Haspeslagh, Maarten; Vlaminck, Lieven E M; Martens, Ann M

    2016-08-01

    OBJECTIVE To evaluate outcomes following treatment of sarcoids in equids and to identify risk factors for treatment failure in these patients. DESIGN Retrospective case series. ANIMALS 230 equids with 614 sarcoids. PROCEDURES Records were searched to identify equids treated for ≥ 1 sarcoid between 2008 and 2013. A standardized protocol was used to determine treatment choice (electrosurgery, electrosurgery with intralesional placement of cisplatin-containing beads, topical administration of imiquimod or acyclovir, cryosurgery, bacillus Calmette-Guerin vaccine injection, or intralesional injection of platinum-containing drugs). Data regarding animal, tumor, treatment, and outcome variables were collected. Complete tumor regression without recurrence for ≥ 6 months was considered a successful outcome. Success rates were calculated; binary logistic regression analysis was used to identify risk factors for treatment failure and to compare effects of the 2 topical treatments. A χ(2) test was used to compare effects of the number of Bacillus Calmette-Guerin vaccine or cisplatin-containing drug injections on outcome. RESULTS The overall success rate was 460 of 614 (74.9%). Electrosurgical excision resulted in the highest treatment success rate (277/319 [86.8%]); odds of treatment failure were significantly greater for intralesional injection of platinum-containing drugs, cryosurgery, and topical acyclovir treatment. Odds of treatment failure were also significantly greater for sarcoids on equids with multiple tumors than for solitary lesions, and significantly lower for sarcoids on equids that received concurrent immunostimulating treatment for another sarcoid than for those on patients that did not receive such treatment. CONCLUSIONS AND CLINICAL RELEVANCE Selection bias for treatments was inherent to the study design; however, results may assist clinicians in selecting treatments and in determining prognosis for equids with sarcoids treated according to the

  6. Evaluation of Viral Meningoencephalitis Cases

    Handan Ilhan

    2012-08-01

    Full Text Available AIM: To evaluate retrospectively adult cases of viral encephalitis. METHOD: Fifteen patients described viral encephalitis hospitalized between the years 2006-2011 follow-up and treatment at the infectious diseases clinic were analyzed retrospectively. RESULTS: Most of the patients (%60 had applied in the spring. Fever (87%, confusion (73%, neck stiffness (73%, headache (73%, nausea-vomiting (33%, loss of consciousness (33%, amnesia (33%, agitation (20%, convulsion (%20, focal neurological signs (13%, Brudzinski-sign (13% were most frequently encountered findings. Electroencephalography test was applied to 13 of 14 patients, and pathological findings compatible with encephalitis have been found. Radiological imaging methods such as CT and MRI were performed in 9 of the 14 patients, and findings consistent with encephalitis were reported. All of initial cerebrospinal fluid (CSF samples were abnormal. The domination of the first examples was lymphocytes in 14 patients; only one patient had an increase in neutrophilic cells have been found. CSF protein level was high in nine patients, and low glucose level was detected in two patients. Herpes simplex virus polymerized chain reaction (PCR analyze was performed to fourteen patients CSF. Only two of them (14% were found positive. One of the patients sample selectively examined was found to be Parvovirus B19 (+, the other patient urine sample Jacobs-creutzfeld virus PCR was found to be positively. Empiric acyclovir therapy was given to all patients. Neuropsychiatric squeal developed at the one patient. CONCLUSION: The cases in the forefront of change in mental status viral meningoencephalitis should be considered and empirical treatment with acyclovir should be started. [TAF Prev Med Bull 2012; 11(4.000: 447-452

  7. Predictors of outcome in HSV encephalitis.

    Singh, Tarun D; Fugate, Jennifer E; Hocker, Sara; Wijdicks, Eelco F M; Aksamit, Allen J; Rabinstein, Alejandro A

    2016-02-01

    This study aims to explore the clinical features, radiological findings, management and the factors influencing prognosis in PCR-confirmed herpes simplex virus encephalitis (HSE). This is a retrospective review of consecutive patients diagnosed with HSE at Mayo Clinic, Rochester, MN, between January 1995 and December 2013. Only HSE cases confirmed by PCR were included. Univariate and multivariate analysis was used to identify factors associated with good (modified Rankin Scale of 0-2) or poor outcome (mRS of 3-6) at hospital discharge and 1-year follow-up. We identified 45 patients with HSE. Median age was 66 (IQR 53.5-78) years. HSE was caused by HSV-1 in 33 cases and by HSV-2 in 9. Nearly half had seizures upon admission or during hospitalization. The most common regions involved on MRI were the temporal lobe in 35 (87.5%), insula in 28 (70.0%), frontal lobe in 27 (67.5%) and thalamus in 11 (27.5%) patients. MRI pattern was quite homogeneous with HSV-1 infection, but much more heterogeneous with HSV-2. Good outcome at discharge and at 6-12 months was seen in 16 (35.6%) and 27 (65.9%) patients, respectively. On multivariate analyses, older age (p = 0.001), coma (p = 0.008), restricted diffusion on MRI (p = 0.005) and acyclovir started after the first day of admission (p = 0.050) were associated with poor outcome at discharge. Older age, development of coma, presence of restricted diffusion on brain MRI and delay in the administration of acyclovir portend poor outcome in HSE. Conversely, presence of seizures, focal neurological deficits, EEG abnormalities and location or extension of FLAIR/T2 abnormalities did not influence functional outcome. PMID:26568560

  8. Herpes zoster em pacientes com lúpus eritematoso sistêmico juvenil Herpes zoster in patients with juvenile systemic lupus erythematosus

    Paula da Silva Neves

    2007-04-01

    VZV. In these patients, the mean age was 16 years and 5 months and the mean duration of the JSLE until the first infection was 4 years. All of these VZV infections were associated with disease activity. All patients presented vesicles and blister lesions along a nerve. The thorax and limbs regions were the most frequently affected. All of the patients received prednisone and 4 cyclophosphamide IV. All patients received acyclovir IV from 7 to 10 days. None of the patients had post-herpetic neuralgia, secondary bacterial infection or died. One patient that was receiving acyclovir had acute blindness by bilateral retinal necrosis vasculitis associated to the VZV, needed two applications of intra-vitreous gancyclovir and immunoglobulin (2 g/kg/dose IV and her vision partially improved. VZV infection in patients with JSLE was rarely observed and was usually associated with disease activity and steroid use. Infection was controlled with acyclovir without serious adverse complications.

  9. Comparison of two different drug therapies for acute retinal necrosis syndrome%对比两种给药方案治疗急性视网膜坏死综合征患者的效果

    袁菁; 胡维琨

    2016-01-01

    AIM: To investigate clinical efficacy of two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin) for acute retinal necrosis syndrome. METHODS: Thirty patients (40 eyes) with acute retinal necrosis syndrome in our hospital were randomly divided into group A and B. Group A was treated with acyclovir with prednisone acetate tablets, and group B was given ganciclovir with prednisone acetate tablets and aspirin. Clinical effects in the two groups were observed and compared. RESULTS: After treatment, the overall response rate in group B (90%) was obviously higher than that in group A (70%), both of two regimens were effective, without significant difference (P>0. 05). There was no significant difference on the pre - treatment visual acuity between the two groups (P>0. 05). After different treatments, the visual acuity in group B was ≥0. 5 in 12 eyes, 0. 1≤and CONCLUSION: Two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin ) both have positive therapeutic effect, but the latter can better restore visual acuity and decrease the complications.%目的:探讨阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+醋酸泼尼松片+阿司匹林两种给药方案治疗急性视网膜坏死综合征的临床疗效。  方法:采用随机数字表法将我院急性视网膜坏死综合征患者30例40眼分为 A、B 两组,其中 A 组采用阿昔洛韦+醋酸泼尼松片的给药方案,B 组采用丙氧鸟苷+醋酸泼尼松片+阿司匹林的给药方案,观察并比较两组患者治疗后的临床效果。  结果:经过治疗后,B 组总有效率(90%)明显高于 A 组(70%),两种给药方案均有效,差异无统计学意义( P>0.05);两组患者在治疗前视力情况差异无统计学意义(P>0.05);经不同给药方案治疗后,A 组视力≥0.5者9眼,视力0.1~  结论:阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+

  10. In vitro cytotoxic, antioxidant and antiviral effects of Pterocaulon alopecuroides and Bidens segetum extracts Efeitos citotóxico, antioxidante e antiviral in vitro de extratos de Pterocaulon alopecuroides e Bidens segetum

    Cristiane Silva Silveira

    2009-06-01

    Full Text Available Pterocaulon alopecuroides (Lamark De Candolle and Bidens segetum Mart. ex Colla are two species belonging to the Asteraceae family. Extracts from those two species were evaluated to their cytotoxic, antioxidant and antiviral activities. All the extracts assayed have shown a very high cytotoxity against RBL-2H3 cell line. The antioxidant assay pointed out a really high activity of the ethyl acetate extracts for B. segetum and P. alopecuroides. This can be partially explained due to the high content of coumarins, at least for P. alopecuroides. None of the total ethanol extracts from B. segetum showed significant activity against the two strains of Herpes simplex virus (Types 1 and 2 resistant to acyclovir. P. alopecuroides ethanol extract was also inactive against the Herpes simplex virus type 1 resistant to acyclovir. However, this extract presented inhibitory activity against the Herpes simplex virus type 2 resistant to acyclovir. From the ethanol crude extract of P. alopecuroides, it was possible to isolate 7-(2',3'-dihidroxy-3'-methylbutyloxy-6-methoxycoumarin, which was tested in the same conditions, showing a viral inhibitory rate almost twice bigger than the P. alopecuroides sample for HSV-2-ACVr. The coumarin was also active against HSV-1-ACVr. Those results provide further evidence of the importance of Pterocaulon alopecuroides and Bidens segetum as medicinal plants.Pterocaulon alopecuroides (Lamark De Candolle e Bidens segetum Mart. ex Colla são duas espécies pertencentes à família Asteraceae. Os extratos dessas duas espécies foram avaliados quanto às suas atividades citotóxica, antioxidante e antiviral. Todos os extratos analisados apresentaram citotoxidade muito alta contra linhagens de células RBL-2H3. O ensaio de atividade antioxidante demonstrou uma alta atividade das frações em acetato de etila de B. segetum e P. alopecuroides. Isso pode ser parcialmente explicado pelo alto conteúdo de cumarinas, ao menos para P

  11. Children with chickenpox:a care of 42 cases%42例小儿水痘护理体会

    陈玉婷

    2014-01-01

    Objective To investigate the methods of care chickenpox in children. Methods Isolation of children, and to give calamine lotion and topical acyclovir ointment, pruritus obvious oral antihistamines. Care items including general care, barrier nursing, nursing fever, skin and blister care, diet care, psychological care, and close observation the changes to prevent complications. Results Of the 42 patients were cured after treatment 7d 23 cases, the cure rate was 54.76%, the total effective 33 cases, the total effective rate was 78.75%, 14d after treatment cured 37 cases, the cure rate was 88.1%, the total effective 42 cases, the total efficiency was 100.00%. Rash face healed without scar formation. Conclusion Variety attentive care measures and calamine lotion and ointment acyclovir topical, has good efficacy, fewer side effects, is one of the better way to treat children with chickenpox.%目的:探讨小儿水痘的护理方法。方法隔离患儿,并给予炉甘石洗剂及阿昔洛韦软膏外用,皮肤瘙痒明显者可口服抗组胺药。包括:一般护理、隔离护理、发热护理、皮肤与水疱护理、饮食护理、心理护理,并密切观察病情变化,以防并发症的发生。结果42例患儿治疗7d后痊愈23例,痊愈率为54.76%,总有效33例,总有效率78.75%,治疗14d后痊愈37例,痊愈率为88.1%,总有效率42例,总有效率为100.00%。皮疹面愈合良好,无瘢痕形成。结论多种细心护理措施和炉甘石洗剂及阿昔洛韦软膏外用,疗效好,副作用较少,是治疗小儿水痘的较好方法之一。

  12. HSV Latency In Vitro : In Situ Hybridization Methods.

    Wilcox, C L; Smith, R L

    1998-01-01

    We have developed an in vitro model of herpes simplex virus (HSV) latency in primary neurons that mimics many aspects of HSV latency in animal models and the human disease (1-3). Using this model, we demonstrated that HSV-1 and HSV-2 establish latent infections in vitro in the same neuronal cell types that are shown to harbor latent HSV in humans (3). Latent HSV infections can be produced in neuronal cultures from ganglia of rodents and primates with similar results (3). In all cases examined, the neurotrophin, nerve growth factor (NGF), is required to maintain the latent infections. Depletion of NGF results in the reactivation of latent virus (1-3). Depending upon the conditions and the use of a high multiplicity of infection, latent HSV-1 infections are established in the majority of primary sensory or sympathetic neurons in tissue culture (2,4). To achieve high efficiency of establishment of latency with little or no evidence of lytic infection, an antiviral agent (e.g., acyclovir) is added to the neuronal cultures during the first week after inoculation with virus. However, latency can be established in the absence of antiviral treatment provided that the multiplicity of infection (MOI) is very low (1,2). At least one of the actions of the antiviral treatment is to prevent amplification of the input virus in the nonneuronal cells that are present in the culture at the outset of the infection. These nonneuronal cells are destroyed in the presence of acyclovir and virus (4). Latency is maintained in neurons in culture for as long as 10 wk in the presence of NGF. Viral transcripts and antigens associated with the productive infection are not detected during the latent infection (2,3,5). Viral transcription is restricted to the latency-associated transcripts (LAT) during the latent infection and is present in the nuclei of 80-90% of the neurons by 3 wk postinfection (4,5) Upon removal of NGF from the culture medium, for as brief as 1 h, reactivation of latent virus

  13. April 2015 critical care case of the month: half-sided light house

    Loftsgard T

    2015-04-01

    Full Text Available No abstract available. Article truncated after 150 words. History of Present Illness: A 55 year old woman was transferred to the ICU from the general medicine ward for tachycardia and acute hypoxic respiratory distress. She has multiple myeloma and had received cycle one of bortezomib, dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide and etoposide (VDT-PACE and radiotherapy to T7 for a pathologic compression. She was admitted for pain control from mucositis.Past Medical History: In addition to the multiple myeloma she has a past medical history of asthma, ovarian cysts, diverticulitis, eczema, pneumonia, laparoscopic cholecystectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy, appendectomy, ectopic pregnancy in the past, and left Bell's palsy. Current Medications: Acyclovir 400 mg BID, Albuterol 90 HFA prn, Allopurinol 300 mg daily, Fluconazole 200 mg BID, Gabapentin 300 mg BID, Hydromorphone , Levofloxacin 500 daily, Morphine, Omeprazole, Bactrim 400-80 mg daily for PCP prophylaxis, Thalomid 200 mg capsule daily, Ativan 0.5 mg just prior to transfer. Physical Examination ...

  14. Virus-Associated Hemophagocytic Syndrome in Renal Transplant Recipients: Report of 2 Cases from a Single Center

    Koji Nanmoku

    2015-01-01

    Full Text Available Virus-associated hemophagocytic syndrome (HPS is a potentially fatal complication of immunosuppression for transplantation. However, it presents with heterogeneous clinical symptoms (fever, disturbed consciousness, and hepatosplenomegaly and laboratory findings (pancytopenia, elevated hepatic enzyme levels, abnormal coagulation, and hyperferritinemia, impeding diagnosis. Case 1: A 39-year-old female developed fever 4 years after ABO-incompatible living-related renal transplantation. Laboratory findings revealed thrombocytopenia, elevated hepatic enzymes, Epstein-Barr virus (EBV DNA seropositivity, and hyperferritinemia. EBV-associated HPS was confirmed by bone marrow aspiration. Steroid pulse therapy and etoposide were ineffective. Disseminated intravascular coagulation resulted in multiple organ failure, and the patient died 32 days after disease onset. Case 2: A 67-year-old male was admitted with rotavirus enteritis a month after living-unrelated renal transplantation. He developed sudden-onset high fever, disturbance of consciousness, and tachypnea 8 days after admission. Laboratory findings revealed elevated hepatic enzyme levels, hyperkalemia, and hyperferritinemia. Emergency continuous hemodiafiltration ameliorated the fever, and steroid pulse therapy improved abnormal laboratory values. Varicella-zoster virus meningitis was confirmed by spinal tap. Acyclovir improved consciousness, and he was discharged 87 days after admission. Fatal virus-associated HPS may develop in organ transplant patients receiving immunosuppressive therapy. Pathognomonic hyperferritinemia is useful for differential diagnosis.

  15. Pharmacokinetic studies and LC-MS/MS method development of ganciclovir and dipeptide monoester prodrugs in Sprague Dawley rats.

    Gunda, Sriram; Earla, Ravinder; Cholkar, Kishore; Mitra, Ashim K

    2015-09-01

    Ganciclovir (GCV) is utilized as an anti-herpetic agent. Reports from our laboratory have suggested that dipeptide ester prodrugs of GCV exhibit high affinity towards the oligopeptide transporter hPEPT1 and therefore seem to be promising candidates for the treatment of oral herpes virus infections. In this study, we have examined the bio-availability of a dipeptide prodrug of GCV after oral administration in jugular cannulated Sprague-Dawley rats. A new bio-analytical method was developed with Q-TRAP liquid chromatography tandem mass spectroscopy (LC-MS/MS) for simultaneous analysis of GCV, Valine-GCV (VGCV) and Tyrosine-Valine-GCV (YVGCV). Acyclovir (ACV) was used as an internal standard in the analysis. Area under plasma-concentration time curves for total concentration of GCV after oral administration of YVGCV was found to be approximately 200 % more than that of GCV following intestinal absorption. A complete conversion of the dipeptide prodrug (YVGCV) to parent compound, GCV, by hepatic first-pass metabolism was evident due to the absence of intermediate metabolite VGCV and administered prodrug YVGCV. The dipeptide prodrugs of GCV exhibit higher systemic availability of regenerated GCV upon oral administration and thus seem to be promising drug candidate in the treatment of systemic herpes infections. PMID:24943988

  16. Fulminant Staphylococcus lugdunensis septicaemia following a pelvic varicella-zoster virus infection in an immune-deficient patient: a case report

    Woznowski M

    2010-09-01

    Full Text Available Abstract Introduction The deadly threat of systemic infections with coagulase negative Staphylococcus lugdunensis despite an appropriate antibiotic therapy has only recently been recognized. The predominant infectious focus observed so far is left-sided native heart valve endocarditis, but bone and soft tissue infections, septicaemia and vascular catheter-related bloodstream infections have also been reported. We present a patient with a fatal Staphylococcus lugdunensis septicaemia following zoster bacterial superinfection of the pelvic region. Case presentation A 71-year old male diagnosed with IgG kappa plasmocytoma presented with a conspicuous weight loss, a hypercalcaemic crisis and acute renal failure. After initiation of haemodialysis treatment his condition improved rapidly. However, he developed a varicella-zoster virus infection of the twelfth thoracic dermatome requiring intravenous acyclovir treatment. Four days later the patient presented with a fulminant septicaemia. Despite an early intravenous antibiotic therapy with ciprofloxacin, piperacillin/combactam and vancomycin the patient died within 48 hours, shortly before the infective isolate was identified as Staphylococcus lugdunensis by polymerase chain reaction. Conclusion Despite S. lugdunensis belonging to the family of coagulase-negative staphylococci with an usually low virulence, infections with S. lugdunensis may be associated with an aggressive course and high mortality. This is the first report on a Staphylococcus lugdunensis septicaemia following a zoster bacterial superinfection of the pelvic region.

  17. Allograft Reaction After Latanoprost use Following Penetrating Keratoplasty for Corneal Scarring due to Herpetic Keratitis

    Tahir Kansu Bozkurt

    2012-03-01

    Full Text Available A 27-year-old male patient with a corneal scar secondary to herpetic keratitis in the right eye underwent penetrating keratoplasty (PK. At the 14th month of follow-up, latanoprost was started to treat high intraocular pressure which was refractory to treatment. On the 15th day of latanoprost use, allograft reaction (AR developed. Insufficient clinical response despite intensive immunosuppressive therapy made us consider the possibility of recurrent herpetic keratouveitis secondary to steroid treatment. The dramatic reduction in the number of keratic precipitates with oral valacyclovir treatment confirmed this diagnosis. The graft remained clear 3 months after the AR treatment. Inflammation in eyes that had undergone PK jeopardizes the graft success by disrupting the immune privilege of anterior chamber. Considering the effects of prostaglandin analogues on blood-aqueous barrier, latanoprost use might have been related to allograft reaction in this case. Another remarkable characteristics of this case was the herpes simplex virus (HSV reactivation secondary to AR therapy. For this reason, oral acyclovir prophylaxis together with AR therapy would improve graft success in cases with HSV history. (Turk J Oph thal mol 2012; 42: 150-3

  18. A REVIEW ARTICLE ON HERPES SIMPLEX ENCEPHALITIS

    A. Karimi MD

    2009-01-01

    Full Text Available Abstract:Herpes Simplex encephalitis (HSE is a life threatening outcome of Herpes simplex virus (HSV infection of the central nervous system (CNS. HSVaccounts for 2-5 percent of all cases of encephalitis. One third of cases occur in those younger than 20 years old and one half in those older than 50 years old.Clinical diagnosis is recommended in the encephalopathic, febrile patients with focal neurological signs. However, the clinical findings are not pathogonomic because numerous other diseases of CNS can mimic HSE. Diagnosis should be confirmed based on medical history, analysis of cerebrospinal fluid (CSF for protein and glucose contents, the cellular analysis and identifying the pathogens by serology and Polymerase Chain Reaction (PCR amplification .The diagnostic gold standard is the detection of HSV DNA in the cerebrospinal fluid by PCR. But negative results need to be interpreted regarding thepatients clinical signs and symptoms and the time of CSF sampling. Spike and slow wave patterns is observed in Electroencephalogram (EEG.Neuroimaging, especially Magnetic Resonance Imaging (MRI is essential for evaluating the patients, which shows temporal lobe edema or hemorrhage.All patients with HSE should be treated by intravenous Acyclovir (10mg/kg q8hr for 14-21 days. After completing therapy, PCR of the CSF can confirmthe elimination of replicating virus, assisting further management of the patient.Keywords:Herpes Simplex Virus (HSV, Encephalitis, Children

  19. A Case of 72 Diabetic Woman with Zoster Paresis

    E. Sajadi

    2009-10-01

    Full Text Available Introduction: VZV is an exclusively human pathogen. The primary infection typically occurs during childhood and causes varicella. As with other members of the herpes viruses’ family, VZV is noninfectious in its latent form but can reactivate at a later time to form intact virions in the involved sensory neurons. These virions then migrate to the skin through axons, spread from cell to cell, and penetrate the epidermis.Case Report: In this case a 72 years old woman with history of diabetes mellitus and hypertension is reported hospitalized because of urinary retention, weakness and parestesia in the right leg, complicated with vesiculoulcerative lesions in sacral area with distribution to the right buttock and vagina. L.P was done to confirm inflammatory radicopathy that showed aseptic meningitis and therapy started with acyclovir and prednisolone. Patient got well and discharged from the hospital.Conclusion: Motor weakness in noncranial nerve is one of the zoster complications known as zoster paresis. Weakness begins suddenly 2-3 weeks after rash and progresses to extremities. In this case 3 weeks after rash, nerve complications were observed. We recommend to do paresthesia examination of skin for eruption in all patients presented with paresis.

  20. 抗水痘-带状疱疹病毒药物的研究进展%Research progress on anti-varicella-zoster virus agents

    沈晔; 陈建华

    2012-01-01

    水痘-带状疱疹病毒(Varicella-Zoster Virus,VZV)是一种α疱疹病毒.VZV的初次感染会引发水痘,之后潜伏于神经节中.VZV的再激活会导致带状疱疹和其他多种神经性疾病.目前阿昔洛韦是首选的抗水痘-带状疱疹病毒药物,近年来其它一些处于研究中的抗水痘-带状疱疹病毒药物都表现出较好的抗病毒活性.%Varicella-zoster virus ( VZV ) is one of alpha-herpes viruses. Primary infection causes varicella ( chickenpox ), after which virus becomes latent. VZV reactivates and causes herpes zoster ( shingles ) and other neurological diseases. Acyclovir is the preferred current anti-VZV agent. In recent years, new molecules in development show improved activity against VZV.

  1. Chickenpox pneumonia. Case presentation. Dora Ngiza hospital, Port Elizabeth, South Africa.

    Gilberto Serrano Ocaña

    2009-03-01

    Full Text Available Chickenpox is an exanthematic highly infectious disease produced by the Varicella zoster virus (VZV, commonly occurs in childhood, 90% of cases occurred in children under 12 years of age, 10% of the population over 15 years is susceptible to suffer it. It is an airborne illness, the inhale virus cause an infection in the initial respiratory epithelium, the virus spreads to distant cells of the reticuloendothelial system, finally, there is a state of viremia with skin lesions, although the spread can also be extended to the viscera. The deterioration of the cell-mediated immunity caused by coexisting diseases, HIV infection, cancer, hemato-oncology illnesses, steroid use, as well as advanced age, smoking, chronic obstructive pulmonary disease and hemorrhagic nature of the Skin lesions, are risk factors for developing Varicella-Zoster pneumonia. In this article we describe a case of chickenpox in a young HIV positive patient complicated with Varicella-Zoster pneumonia. Despite of the treatment with acyclovir, prednisone and supportive measures had a fatal outcome.

  2. Chickenpox Chorioretinitis with Retinal Exudates and Periphlebitis

    Hirokuni Kitamei

    2012-05-01

    Full Text Available Background: Chickenpox is rarely associated with posterior segment inflammation. We report on a case of unilateral chickenpox chorioretinitis with retinal exudates and periphlebitis. Case Presentation: A 21-year-old healthy man, who suffered from chickenpox 2 weeks prior to symptom development, exhibited mild anterior chamber cells, vitreous opacity, sheathing of retinal veins, and yellow-white exudates in his right eye. Varicella zoster virus DNA was detected by polymerase chain reaction in the aqueous humor. He was treated with intravenous acyclovir followed by oral prednisolone and valaciclovir. Aqueous cells quickly disappeared and retinal exudates diminished within 1 month, leaving faint retinal scarring. Retinal arteritis had never been observed in this patient. Conclusions: Although the ocular findings in this case were similar to acute retinal necrosis (ARN, the clinical features differed from ARN in the following points: (1 mild anterior chamber inflammation, (2 absence of retinal arteritis, and (3 prompt resolution of inflammatory findings. The distinctive clinical features indicated that chorioretinitis associated with chickenpox may not have the same pathological conditions as ARN.

  3. Varicella pneumonia in adults: 13 years′ experience with review of literature

    Alanezi Mohammed

    2007-01-01

    Full Text Available Pneumonia is a serious complication of varicella infection in adults. This study investigates the clinical characteristics in 19 patients admitted to our hospital with diagnosis of Varicella pneumonia . Materials and Methods : A retrospective chart review study was performed in adult patients admitted with diagnosis of Varicella pneumonia over 13 years (1992-2005. The study documented the clinical characteristics, laboratory investigations, hospital course, complications, treatment received and the outcomes. Results : Nineteen patients were identified with a mean age of 41 (±15.4. All were males except two. Eleven patients (58% were smokers. Eleven patients (58% had direct contact with persons with chickenpox infection. One patient had underlying chronic pulmonary disease (sarcoidosis. Sixteen patients (84% were admitted to the intensive care unit due to respiratory failure; eight of them required mechanical ventilation. The mean duration of ICU stay was 4.4 days. All patients were treated with acyclovir and IV antibiotics. Three patients received IV steroid. There was one death. Conclusion : Patients with Varicella pneumonia are at high risk for respiratory failure and the need for mechanical ventilation. However, early implementation of supportive therapy seems to positively influence the recovery rate and outcome.

  4. Diagnosis and management of herpes zoster by the family and community physician

    Pedro Alexandre Barreto Coelho

    2014-08-01

    Full Text Available The herpes virus that causes varicella (chickenpox persists in a latent form in the nervous system and can reactivate and propagate through nerve roots, manifesting years later through painful skin lesions, a condition called herpes zoster. The diagnosis is primarily clinical, but it is important to make a differential diagnosis with impetigo, contact dermatitis, dermatitis herpetiformis and also herpes simplex itself. After the diagnosis is confirmed, treatment should be initiated within the first 72 hours after onset of the rash and it is based upon antiviral therapy. Valacyclovir and famciclovir are more effective when compared to acyclovir. The most common complication of herpes zoster is post-herpetic neuralgia, usually managed with tricyclic antidepressants, anticonvulsants, topical lidocaine or capsaicin. Recently, a live attenuated vaccine against herpes zoster was introduced in Brazil, with the same components as the vaccine against varicella, but in a greater concentration. However, it still has a high cost and is not available in the public health system.

  5. Coincidence of Varicella-Zoster Virus Anterior Uveitis in a Patient with Chandler's Syndrome

    Takeshi Joko

    2013-11-01

    Full Text Available Purpose: We report a patient who, based on the clinical manifestations, was originally diagnosed as having Chandler's syndrome and later developed varicella-zoster virus (VZV DNA-positive anterior uveitis. Methods: The patient with Chandler's syndrome who manifested anterior uveitis underwent a complete ophthalmologic examination. Polymerase chain reaction (PCR was used to amplify the viral DNA in the aqueous humor to determine the cause of the intraocular inflammation. Results: Slit-lamp biomicroscopy showed focal iris atrophy and peripheral anterior synechiae (PAS; specular microscopy of the corneal endothelium disclosed the hammered-silver appearance. Based on these clinical findings, we diagnosed this patient as having Chandler's syndrome. During the follow-up period, however, the inflammatory cells suddenly appeared in the anterior chamber with formation of keratic precipitates and an increased intraocular pressure (IOP. VZV DNA was displayed in the aqueous humor by PCR. Based upon the diagnosis of VZV anterior uveitis, corticosteroids and acyclovir were given topically and systemically. The inflammation subsided with these medications; however, trabeculectomy was finally needed to control the IOP due to PAS progression. Conclusion: The coincidence of VZV anterior uveitis with Chandler's syndrome may constitute an implication for the possible viral etiology of iridocorneal endothelial syndrome.

  6. Detection of Vero Cells Infected with Herpes Simplex Types 1 and 2 and Varicella Zoster Viruses Using Raman Spectroscopy and Advanced Statistical Methods

    Huleihel, Mahmoud; Shufan, Elad; Zeiri, Leila; Salman, Ahmad

    2016-01-01

    Of the eight members of the herpes family of viruses, HSV1, HSV2, and varicella zoster are the most common and are mainly involved in cutaneous disorders. These viruses usually are not life-threatening, but in some cases they might cause serious infections to the eyes and the brain that can lead to blindness and possibly death. An effective drug (acyclovir and its derivatives) is available against these viruses. Therefore, early detection and identification of these viral infections is highly important for an effective treatment. Raman spectroscopy, which has been widely used in the past years in medicine and biology, was used as a powerful spectroscopic tool for the detection and identification of these viral infections in cell culture, due to its sensitivity, rapidity and reliability. Our results showed that it was possible to differentiate, with a 97% identification success rate, the uninfected Vero cells that served as a control, from the Vero cells that were infected with HSV-1, HSV-2, and VZV. For that, linear discriminant analysis (LDA) was performed on the Raman spectra after principal component analysis (PCA) with a leave one out (LOO) approach. Raman spectroscopy in tandem with PCA and LDA enable to differentiate among the different herpes viral infections of Vero cells in time span of few minutes with high accuracy rate. Understanding cell molecular changes due to herpes viral infections using Raman spectroscopy may help in early detection and effective treatment. PMID:27078266

  7. Herpes simplex ulcerative esophagitis in healthy children

    Abdulrahman A Al-Hussaini

    2011-01-01

    Full Text Available Herpes simplex virus is a common cause of ulcerative esophagitis in the immunocompromised or debilitated host. Despite a high prevalence of primary and recurrent Herpes simplex virus infection in the general population, Herpes simplex virus esophagitis (HSVE appears to be rare in the immunocompetent host. We report three cases of endoscopically-diagnosed HSVE in apparently immunocompetent children; the presentation was characterized by acute onset of fever, odynophagia, and dysphagia. In two cases, the diagnosis was confirmed histologically by identification of herpes viral inclusions and culture of the virus in the presence of inflammation. The third case was considered to have probable HSVE based on the presence of typical cold sore on his lip, typical endoscopic finding, histopathological evidence of inflammation in esophageal biopsies and positive serologic evidence of acute Herpes simplex virus infection. Two cases received an intravenous course of acyclovir and one had self-limited recovery. All three cases had normal immunological workup and excellent health on long-term follow-up.

  8. Herpes simplex virus encephalitis in Peru: a multicentre prospective study.

    Montano, S M; Mori, N; Nelson, C A; Ton, T G N; Celis, V; Ticona, E; Sihuincha, M; Tilley, D H; Kochel, T; Zunt, J R

    2016-06-01

    Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009-2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru. PMID:26733400

  9. Dancing with chemical formulae of antivirals: A panoramic view (Part 2).

    De Clercq, Erik

    2013-11-15

    In this second part of "Dancing with antivirals as chemical formulae" I will focus on a number of chemical compounds that in the last few years have elicited more than common attraction from a commercial viewpoint: (i) favipiravir (T-705), as it is active against influenza, but also several other RNA viruses; (ii) neuraminidase inhibitors such as zanamivir and oseltamivir; (iii) peramivir and laninamivir octanoate, which might be effective against influenza virus following a single (intravenous or inhalation) administration; (iv) sofosbuvir, the (anticipated) cornerstone for the interferon-free therapy of HCV infections; (v) combinations of DAAs (direct antiviral agents) to achieve, in no time, a sustained virus response (SVR) against HCV infection; (vi) HIV protease inhibitors, the latest and most promising being darunavir; (vii) the integrase inhibitors (INIs) (raltegravir, elvitegravir, dolutegravir), representing a new dimension in the anti-HIV armamentarium; (viii), a new class of helicase primase inhibitors (HPIs) that may exceed acyclovir and the other anti-herpes compounds in both potency and safety; (ix) CMX-001, as the latest of Dr. Antonín Holý's legacy for its activity against poxviruses and CMV infections, and (x) noroviruses for which the ideal antiviral compounds are still awaited for. PMID:24070654

  10. Síndrome Beguez-Chediak-Higashi. Comunicación de un nuevo caso en Cuba Beguez Chediak-Higashi Syndrome. Report of a new case in Cuba

    Sergio Machín García

    2011-12-01

    Full Text Available El síndrome de Beguez-Chediak-Higashi es una enfermedad rara, autosómica recesiva, descrita en Cuba por el Dr. Beguez-César en 1943. Se presenta un paciente masculino de 8 meses de edad con antecedentes de infecciones graves, obesidad, palidez cutáneo-mucosa intensa, cabello de color plateado, hepatoesplenomegalia y anemia con presencia de gránulos lisosomales gigantes en las células del sistema granulopoyético. Se trató con prednisona, vincristina, etopósido y aciclovir oral con respuestas parciales y transitorias.Beguez-Chediak-Higashi syndrome is a rare illness; it was described in 1943 by Dr. Beguez-Cesar in Cuba. We present an 8 months boy with frequent infections, obesity, intense paleness, silver hair, hepatomegaly, splenomegaly, anemia and big lisosomal granules in myelopoietic system. He was treated with prednisolona, vincristin, VP-16, and oral acyclovir with partial and transitory results.

  11. Complementary assays for monitoring susceptibility of varicella-zoster virus resistance to antivirals.

    Perrier, Marine; Désiré, Nathalie; Deback, Claire; Agut, Henri; Boutolleau, David; Burrel, Sonia

    2016-07-01

    The emergence of varicella-zoster virus (VZV) resistance to current antivirals as acyclovir (ACV) constitutes a hindrance to antiviral treatment effectiveness of VZV infections, especially in immunocompromised patients. The molecular mechanisms of VZV resistance reported so far rely on the presence of mutations within thymidine kinase (TK, ORF36) and DNA polymerase (ORF28) viral genes. The aim of this work was to develop reliable and complementary diagnostic methods to detect VZV antiviral resistance: (i) a genotypic assay based on TK and DNA polymerase genes sequencing, (ii) a plaque reduction assay to determine antiviral 50% effective concentrations, and (iii) a functional assay to evaluate in vitro phosphorylation activity of recombinant TKs. As a whole, this study included the analysis of 21 VZV clinical isolates and 62 biological samples from patients experiencing VZV infection. Genetic analysis revealed 3 and 9 new amino acid changes that have not been previously described within the highly conserved TK and DNA polymerase, respectively. Then, VZV isolates bearing newly identified mutations considered as natural polymorphisms were characterized as susceptible to ACV using plaque-reduction assay in MeWo cells. In parallel, the impact of TK changes on ACV phosphorylation activity was examined using a nonradioactive in vitro enzymatic assay. PMID:26994966

  12. Pentagalloylglucose Blocks the Nuclear Transport and the Process of Nucleocapsid Egress to Inhibit HSV-1 Infection.

    Jin, Fujun; Ma, Kaiqi; Chen, Maoyun; Zou, Muping; Wu, Yanting; Li, Feng; Wang, Yifei

    2016-03-23

    Herpes simplex virus type 1 (HSV-1), a widespread virus, causes a variety of human viral diseases worldwide. The serious threat of drug-resistance highlights the extreme urgency to develop novel antiviral drugs with different mechanisms of action. Pentagalloylglucose (PGG) is a natural polyphenolic compound with significant anti-HSV activity; however, the mechanisms underlying its antiviral activity need to be defined by further studies. In this study, we found that PGG treatment delays the nuclear transport process of HSV-1 particles by inhibiting the upregulation of dynein (a cellular major motor protein) induced by HSV-1 infection. Furthermore, PGG treatment affects the nucleocapsid egress of HSV-1 by inhibiting the expression and disrupting the cellular localization of pEGFP-UL31 and pEGFP-UL34, which are indispensable for HSV-1 nucleocapsid egress from the nucleus. However, the over-expression of pEGFP-UL31 and pEGFP-UL34 could decrease the antiviral effect of PGG. In this study, for the first time, the antiviral activity of PGG against acyclovir-resistant virus was demonstrated in vitro, and the possible mechanisms of its anti-HSV activities were identified based on the inhibition of nuclear transport and nucleocapsid egress in HSV-1. It was further confirmed that PGG could be a promising candidate for HSV therapy, especially for drug-resistant strains. PMID:26166506

  13. [A Case of Acute Acalculous Cholecystitis During Infectious Mononucleosis Caused by the Epstein-Barr Virus in a Young Woman].

    Ono, Shiro; Kobayashi, Tadanao; Nishio, Kenji

    2016-05-01

    Infection with the Epstein-Barr virus (EBV) is a common disease and is mainly asymptomatic during childhood, whereas infectious mononucleosis with clinical signs such as fever, pharyngitis, lymphadenopathy and hepatosplenomegaly often occurs in adolescents and adults with primary infection. Acalculous cholecystitis has been reported as a rare complication. We report herein a case of acalculous cholecystitis accompanied by infectious mononucleosis by EBV, which was treated successfully by medical treatment. A 33-year-old woman who had been admitted by fever, pharyngitis and lymphadenopathy developed a right upper quadrant pain, that was diagnosed as acalculous cholecystitis based on an imaging study. Antibiotic treatment did not resolve the symptoms, and surgical intervention was considered. We diagnosed her as having infectious mononucleosis based on a typical physical presentation and seropositivity for the EBV viral capsid antigen, suggesting that the acalculous cholecystatis might have been a complication of the EBV infection. After the administration of glucocorticoid and acyclovir, the patient became afebrile and the abdominal pain disappeared. Though acalculous cholecystitis rarely accompanies infectious mononucleosis caused by EBV, clinicians should be aware of this complication to avoid unnecessary cholecystectomy. PMID:27529970

  14. Feasibility Investigation of Cellulose Polymers for Mucoadhesive Nasal Drug Delivery Applications.

    Hansen, Kellisa; Kim, Gwangseong; Desai, Kashappa-Goud H; Patel, Hiren; Olsen, Karl F; Curtis-Fisk, Jaime; Tocce, Elizabeth; Jordan, Susan; Schwendeman, Steven P

    2015-08-01

    The feasibility of various cellulose polymer derivatives, including methylcellulose (MC), hydroxypropyl methylcellulose (HPMC), sodium-carboxymethylcellulose (sodium-CMC), and cationic-hydroxyethylcellulose (cationic-HEC), for use as an excipient to enhance drug delivery in nasal spray formulations was investigated. Three main parameters for evaluating the polymers in nasal drug delivery applications include rheology, ciliary beat frequency (CBF), and permeation across nasal tissue. Reversible thermally induced viscosity enhancement was observed at near nasal physiological temperature when cellulose derivatives were combined with an additional excipient, poly(vinyl caprolactam)-poly(vinyl acetate)-poly(ethylene glycol) graft copolymer (PVCL-PVA-PEG). Cationic-HEC was shown to enhance acyclovir permeation across the nasal mucosa. None of the tested cellulosic polymers caused any adverse effects on porcine nasal tissues and cells, as assessed by alterations in CBF. Upon an increase in polymer concentration, a reduction in CBF was observed when ciliated cells were immersed in the polymer solution, and this decrease returned to baseline when the polymer was removed. While each cellulose derivative exhibited unique advantages for nasal drug delivery applications, none stood out on their own to improve more than one of the performance characteristics examined. Hence, these data may be useful for the development of new cellulose derivatives in nasal drug formulations. PMID:26097994

  15. Atypical manifestation of progressive outer retinal necrosis in AIDS patient with CD4+ T-cell counts more than 100 cells/microL on highly active antiretroviral therapy.

    Vichitvejpaisal, Pornpattana; Reeponmahar, Somporn; Tantisiriwat, Woraphot

    2009-06-01

    Typical progressive outer retinal necrosis (PORN) is an acute ocular infectious disease in acquired immunodeficiency syndrome (AIDS) patients with extremely low CD4+ T-cell counts. It is a form of the Varicella- zoster virus (VZV) infection. This destructive infection has an extremely rapid course that may lead to blindness in affected eyes within days or weeks. Attempts at its treatment have had limited success. We describe the case of a bilateral PORN in an AIDS patient with an initial CD4+ T-cell count >100 cells/microL that developed after initiation of highly active antiretroviral therapy (HAART). A 29-year-old Thai female initially diagnosed with human immunodeficiency virus (HIV) in 1998, presented with bilaterally decreased visual acuity after initiating HAART two months earlier. Multiple yellowish spots appeared in the deep retina without evidence of intraocular inflammation or retinal vasculitis. Her CD4+ T-cell count was 127 cells/microL. She was diagnosed as having PORN based on clinical features and positive VZV in the aqueous humor and vitreous by polymerase chain reaction (PCR). Despite combined treatment with intravenous acyclovir and intravitreous ganciclovir, the patient's visual acuity worsened with no light-perception in either eye. This case suggests that PORN should be included in the differential diagnosis of reduced visual acuity in AIDS patients initiating HAART with higher CD4+ T-cell counts. PORN may be a manifestation of the immune reconstitution syndrome. PMID:19702067

  16. 1990 Sir Henry Wellcome medal and prize winner. Leukoregulin: a new biotherapeutic cytokine in the search for more effective anti-viral pharmacologic agents.

    Evans, C H; Hooks, J J; Detrick, B

    1991-04-01

    This investigation examines whether cytokines, as exemplified by leukoregulin, with their immense potential for biorecognition and target cell modulation as a result of their complex three-dimensional structure, have the potential to provide new directions for biotherapy of infectious disease. Leukoregulin is a naturally occurring immunologic cytokine, secreted by stimulated lymphocytes, which increases membrane permeability and drug uptake in tumor but not in normal cells. This study demonstrates that leukoregulin also increases the plasma membrane permeability of cells acutely infected with herpes simplex type 1 virus and that the increase in membrane permeability is accompanied by a 10- to 100-fold increase in the ability of acyclovir to inhibit the release of infectious virus when the cells are treated with leukoregulin 3 hours after infection with the virus. This is the first demonstration that a cytokine, alone or in combination with anti-viral chemotherapy, can effectively inhibit virus replication in human cells following acute virus infection, which indicates that combination immunotherapy and chemotherapy have the potential to completely inhibit the production of infectious virus by acutely infected human cells. PMID:1851546

  17. Prolonged varicella-zoster virus reinfection in an adult after unrelated cord blood transplantation

    Masahiro Oka

    2012-01-01

    Full Text Available Most varicella-zoster virus (VZV infections after cord blood transplantation (CBT present as localized herpes zoster. Here, we report a case of VZV reinfection in an adult patient after CBT that appeared clinically to be varicella. A 50-year-old Japanese man underwent CBT for the management of acute lymphoblastic leukemia. Seventeen months later, he developed a small number of vesicles with umbilicated centers. A skin biopsy showed an intraepidermal blister containing degenerated balloon cells. Subsequently, the skin eruption developed over his entire body. The patient was treated with intravenous acyclovir for 5 days, followed by oral valacyclovir for 9 days. It took more than 3 weeks for most of the skin lesions to scab. Serum levels of anti-VZV IgG on days 3 and 33 after the onset of the skin eruption were negative and 260 mIU/ml, respectively. Serum anti-VZV IgM on days 3 and 33 was not detected. Our patient was diagnosed with VZV reinfection.

  18. Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report

    Mazzola Giovanni

    2011-03-01

    Full Text Available Abstract Blackground It is well-known that Epstein-Barr virus (EBV can affect the central nervous system (CNS. Case presentation Herein the authors report unusual timely Magnetic Resonance Imaging (MRI brain scan findings in an immunocompetent patient with EBV encephalitis. Diffusion weighted MRI sequence performed during the acute phase of the disease was normal, whereas the Fast Relaxation Fast Spin Echo T2 image showed diffuse signal intensity changes in white matter. The enhancement pattern suggested an inflammatory response restricted to the brain microcirculation. Acyclovir and corticosteroid therapy was administered. After three weeks, all signal intensities returned to normal and the patient showed clinical recovery. Conclusion This report demonstrates that EBV in an immunocompetent adult can present with diffuse, reversible brain white matter involvement in the acute phase of mononucleosis. Moreover, our case suggests that a negative DWI sequence is associated with a favorable improvement in severe EBV CNS infection. More extensive studies are needed to assess what other instrumental data can help to distinguish viral lesions from other causes in the acute phase of disease.

  19. A novel corneal explant model system to evaluate antiviral drugs against feline herpesvirus type 1 (FHV-1).

    Pennington, Matthew R; Fort, Michael W; Ledbetter, Eric C; Van de Walle, Gerlinde R

    2016-06-01

    Feline herpesvirus type-1 (FHV-1) is the most common viral cause of ocular surface disease in cats. Many antiviral drugs are used to treat FHV-1, but require frequent topical application and most lack well-controlled in vivo studies to justify their clinical use. Therefore, better validation of current and novel treatment options are urgently needed. Here, we report on the development of a feline whole corneal explant model that supports FHV-1 replication and thus can be used as a novel model system to evaluate the efficacy of antiviral drugs. The anti-herpes nucleoside analogues cidofovir and acyclovir, which are used clinically to treat ocular herpesvirus infection in cats and have previously been evaluated in traditional two-dimensional feline cell cultures in vitro, were evaluated in this explant model. Both drugs suppressed FHV-1 replication when given every 12 h, with cidofovir showing greater efficacy. In addition, the potential efficacy of the retroviral integrase inhibitor raltegravir against FHV-1 was evaluated in cell culture as well as in the explant model. Raltegravir was not toxic to feline cells or corneas, and most significantly, inhibited FHV-1 replication at 500 µM in both systems. Importantly, this drug was effective when given only once every 24 h. Taken together, our data indicate that the feline whole corneal explant model is a useful tool for the evaluation of antiviral drugs and, furthermore, that raltegravir appears a promising novel antiviral drug to treat ocular herpesvirus infection in cats. PMID:26959283

  20. Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report

    It is well-known that Epstein-Barr virus (EBV) can affect the central nervous system (CNS). Herein the authors report unusual timely Magnetic Resonance Imaging (MRI) brain scan findings in an immunocompetent patient with EBV encephalitis. Diffusion weighted MRI sequence performed during the acute phase of the disease was normal, whereas the Fast Relaxation Fast Spin Echo T2 image showed diffuse signal intensity changes in white matter. The enhancement pattern suggested an inflammatory response restricted to the brain microcirculation. Acyclovir and corticosteroid therapy was administered. After three weeks, all signal intensities returned to normal and the patient showed clinical recovery. This report demonstrates that EBV in an immunocompetent adult can present with diffuse, reversible brain white matter involvement in the acute phase of mononucleosis. Moreover, our case suggests that a negative DWI sequence is associated with a favorable improvement in severe EBV CNS infection. More extensive studies are needed to assess what other instrumental data can help to distinguish viral lesions from other causes in the acute phase of disease

  1. Herpes zoster virus: an unusual but potentially treatable cause of sciatica and foot drop.

    Sprenger De Rover, Walter B; Alazzawi, Sulaiman; Hallam, Peter J; Hutchinson, Rachael; Di Mascio, Livio

    2011-12-01

    The herpes zoster virus is a rare but potential cause of acute motor weakness. This article describes 2 patients with drop foot secondary to an infection of varicella zoster who were incorrectly referred to an orthopedic clinic from their general practitioners. The first patient was a 74-year-old man who presented with weakness in the right foot and a vesicular rash. The pattern of disease supported the clinical diagnosis of shingles affecting the L5 motor and sensory division. No investigation was required, and the patient was treated with a foot drop splint. The second patient was a 71-year-old man who presented with right leg and foot weakness and a vesicular rash affecting his right buttock and posterior right thigh. Lumbar magnetic resonance excluded a stenotic lesion; electrophysiological studies supported the diagnosis of a lower motor neuron lesion. The patient was treated with a 1-week course of acyclovir and a foot drop splint. The correct diagnosis will aid in correct referral and will prompt management, which will potentially provide a faster and better outcome for the patient. PMID:22146220

  2. Antiviral medication in sexually transmitted diseases. Part I: HSV, HPV.

    Mlynarczyk-Bonikowska, Beata; Majewska, Anna; Malejczyk, Magdalena; Mlynarczyk, Grazyna; Majewski, Slawomir

    2013-11-01

    Sexually transmitted diseases (STD) are one of the most prevalent infectious diseases in the world and important cause of morbidity and mortality. Especially STDs of viral etiology are difficult to cure. In many cases the antiviral therapy can relieve the symptoms but not eliminate the virus. During the past decades, considerable progress has been made in the development of antiviral drugs. One of the oldest antiviral medications is acyclovir (ACV). It is approved to treat initial and recurrent genital herpes and as a suppressive therapy in severe recurrent genital infections as well. Drug resistance to ACV and related drugs is seen among immunocompromised hosts, including human immunodeficiency virus HIV-infected patients. Resistant infections can be managed by second-line drugs - foscarnet or cidofovir- but they are more toxic than ACV. In case of HPV there is not known specific target for the medication and that is why the substances used in human papilloma virus HPV infection therapy are either antimitotics or immunomodulators. The Part I review focuses on mechanisms of actions and mechanisms of resistance to antiviral agents used in a treatment of the genital herpes and genital HPV infection. In Part II we will show the therapeutic options in other sexually transmitted infections: hepatitis B, C and HIV. PMID:24032509

  3. Platinum(II and Palladium(II Complexes of Pyridine-2-Carbaldehyde Thiosemicarbazone as Alternative Antiherpes Simplex Virus Agents

    D. Kovala-Demertzi

    2007-01-01

    Full Text Available The cytotoxicity and the antivirus activity of Pd(II and Pt(II complexes with pyridine-2-carbaldehyde thiosemicarbazone (HFoTsc against HSV replication were evaluated on four HSV strains—two wt strains Victoria (HSV-1 and BJA (HSV-2 and two ACVR mutants with different tk gene mutations R-100 (TKA, HSV-1 and PU (TKN, HSV-2. The experiments were performed on continuous MDBK cells and four HSV 1 and HSV 2 strains were used, two sensitive to acyclovir and two resistant mutants. The five complexes of HFoTsc, [Pt(FoTscCl], [Pt(FoTsc(H2FoTsc]Cl2, [Pt(FoTsc2], [Pd(FoTsc(H2FoTsc]Cl2, and [Pd(FoTsc2], were found to be effective inhibitors of HSV replication. The most promising, active, and selective anti-HSV agent was found to be complex [Pt(FoTsc(H2FoTsc]Cl2. This complex could be useful in the treatment of HSV infections, since it is resistant to ACV mutants. PCR study of immediate early 300 bp ReIV Us1 region reveals that the complex [Pt(FoTsc(H2FoTsc]Cl2 specifically suppressed wt HSV-1 genome 2 hours after the infection, not inducing apoptosis/necrosis on the 8 hours after virus infection. The target was found to be most probably the viral, instead of the host cell DNA.

  4. Case of herpes simplex encephalitis(HSE) with a thalamic lesion

    Fujimori, K.; Koike, R.; Yuasa, T.; Miyatake, T.; Ito, J.

    1987-02-01

    A case of herpes simplex encephalitis (HSE) with thalamic involvement was reported. The patient, a 27-year-old man, was admitted because of abnormal behavior and fever. He exhibited a disturbance of consciousness, meningial signs, and hyperreflexia. A CT scan of the head revealed diffuse brain edema. Acute encephalitis, especially HSE, was suspected, and so the intravenous administration of acyclovir and steroid therapy were started. The titer of herpes simplex Type 1 virus, as measured by CF and ELISA, was found to have increased amounts of serum and cerebrospinal fluid. 5 days after the onset, his consciousness worsened. He could not tell his name and scarely opened his eyes upon pain stimulation. A CT scan at this time showed low-density lesions in the left thalamus, cingulate gyrus, and the posterior portion of the putamen. About 5 days later, his consciousness level was increased, but he was mute. This symptom was thought to be thalamic aphasia, which might be correlative with the low-density lesions shown in the left thalamus by the CT scan. About 30 days after the onset of the disease, his speech became normal, and a CT scan at 51 hospital days showed no abnormality. The etiology of low-density lesions of the left thalamus in the CT scan is speculated to be as follows: firstly, vascular damage of circulation disturbance, and secondly a special affinity of herpes simplex Type 1 virus to the thalamus.

  5. Varicella-Zoster-Mediated Radiculitis Reactivation following Cervical Spine Surgery: Case Report and Review of the Literature

    Doniel Drazin

    2013-01-01

    Full Text Available Varicella-zoster virus and herpes simplex virus types 1 and 2 are neurotropic viruses that can be reactivated after a surgical or stressful intervention. Although such cases are uncommon, consequences can be debilitating, and variable treatment responses merit consideration. We describe a 41-year-old male with a history of varicella-mediated skin eruptions, who presented with continuing right arm pain, burning, and numbness in a C6 dermatomal distribution following a C5-6 anterior cervical discectomy and fusion and epidural steroid injections. The operative course was uncomplicated and he was discharged home on postoperative day 1. Approximately ten days after surgery, the patient presented to the emergency department complaining of severe pain in his right upper extremity and a vesicular rash from his elbow to his second digit. He was started on Acyclovir and discharged home. On outpatient follow-up, his rash had resolved though his pain continued. The patient was started on a neuromodulating agent for chronic pain. This case adds to the limited literature regarding this rare complication, brings attention to the symptoms for proper diagnosis and treatment, and emphasizes the importance of prompt antiviral therapy. We suggest adding a neuromodulating agent to prevent long-term sequelae and resolve acute symptoms.

  6. Valacyclovir in the treatment of acute retinal necrosis

    Taylor Simon RJ

    2012-09-01

    Full Text Available Abstract Background To report the outcome of oral valacyclovir as the sole antiviral therapy for patients with acute retinal necrosis (ARN. Methods This study reports a retrospective, interventional case series of nine consecutive patients with ten eyes with newly diagnosed ARN treated with oral valacyclovir as the sole antiviral agent. Eight patients received oral valacyclovir 2 g tid (Valtrex, GlaxoSmithKline and one patient with impaired renal function received oral 1 g tid. The main outcome measures were response to treatment, time to initial response to treatment, time to complete resolution of retinitis, best corrected visual acuity (BCVA at final follow-up, retinal detachment and development of recurrent or second eye disease. Results Retinitis resolved in ten of ten (100% affected eyes. The median time to initial detectable response was seven days and the median time to complete resolution was 21 days. A final BCVA of 20/40 or better was achieved in 6/10 (60% of eyes. 3/10 eyes (30% developed a retinal detachment. No patients developed either disease reactivation or second eye involvement over the course of the study (mean follow up 31 weeks, range 7 to 104 weeks. Conclusions Treatment with oral valacyclovir as the sole antiviral therapy resulted in complete resolution of retinitis. Final BCVA and retinal detachment rate were comparable with previously reported outcomes for intravenous acyclovir.

  7. A Young Woman with Ischemic Stroke: Should We Pay More Attention to Varicella Zoster Infection?

    Borbinha, Cláudia; Marto, João Pedro; Calado, Sofia; Viana-Baptista, Miguel

    2016-01-01

    Ischemic and hemorrhagic stroke are recognized complications of Varicella zoster virus (VZV) infections, although uncommon and poorly documented. The authors report the case of a 31-year-old woman admitted with acute ischemic stroke of the right posterior cerebral artery and a history of a thoracic rash 1 month before. Aspirin and simvastatin were prescribed, but the patient suffered a stepwise deterioration the following days, with new areas of infarction on brain imaging. Despite no evidence of cardiac or large vessel embolic sources, anticoagulation was started empirically 6 days after stroke onset. One week later, symptomatic hemorrhagic transformation occurred. The diagnosis of VZV vasculopathy was then considered, and treatment with acyclovir and prednisolone was started with no further vascular events. Cerebrospinal fluid analysis and digital subtraction angiography findings corroborated the diagnosis. The patient was discharged to the rehabilitation center with a modified Rankin scale (mRS) score of 4. On the 6-month follow-up, she presented only a slight disability (mRS score 2). In conclusion, VZV vasculopathy needs to be considered in young adults with stroke. A high index of suspicion and early treatment seem to be important to minimize morbidity and mortality. Anticoagulation should probably be avoided in stroke associated with VZV vasculopathy. PMID:27504091

  8. Inhibitory effect of essential oils against herpes simplex virus type 2.

    Koch, C; Reichling, J; Schneele, J; Schnitzler, P

    2008-01-01

    Essential oils from anise, hyssop, thyme, ginger, camomile and sandalwood were screened for their inhibitory effect against herpes simplex virus type 2 (HSV-2) in vitro on RC-37 cells using a plaque reduction assay. Genital herpes is a chronic, persistent infection spreading efficiently and silently as sexually transmitted disease through the population. Antiviral agents currently applied for the treatment of herpesvirus infections include acyclovir and its derivatives. The inhibitory concentrations (IC50) were determined at 0.016%, 0.0075%, 0.007%, 0.004%, 0.003% and 0.0015% for anise oil, hyssop oil, thyme oil, ginger oil, camomile oil and sandalwood oil, respectively. A clearly dose-dependent virucidal activity against HSV-2 could be demonstrated for all essential oils tested. In order to determine the mode of the inhibitory effect, essential oils were added at different stages during the viral infection cycle. At maximum noncytotoxic concentrations of the essential oils, plaque formation was significantly reduced by more than 90% when HSV-2 was preincubated with hyssop oil, thyme oil or ginger oil. However, no inhibitory effect could be observed when the essential oils were added to the cells prior to infection with HSV-2 or after the adsorption period. These results indicate that essential oils affected HSV-2 mainly before adsorption probably by interacting with the viral envelope. Camomile oil exhibited a high selectivity index and seems to be a promising candidate for topical therapeutic application as virucidal agents for treatment of herpes genitalis. PMID:17976968

  9. Virucidal activity and chemical composition of essential oils from aromatic plants of central west Argentina.

    García, Cybele C; Acosta, Eliana G; Carro, Ana C; Fernández Belmonte, María C; Bomben, Renata; Duschatzky, Claudia B; Perotti, Marina; Schuff, Carola; Damonte, Elsa B

    2010-08-01

    The essential oils of seven aromatic plants from central west Argentina were isolated by steam distillation and analyzed by a gas chromatography/mass spectrometry technique. The oils were screened for cytotoxicity and in vitro inhibitory activity against herpes simplex virus type 1 (HSV-1), dengue virus type 2 (DENV-2) and Junin virus (JUNV). The oils showed a variable virucidal action according to the virus. JUNV was the least susceptible virus in comparison with HSV-1 and DENV-2. The better relationship between cytotoxicity and inhibitory activity was observed for the essential oil of Lantana grisebachiii (Seckt.) var. grisebachii against DENV-2 and HSV-1 with IC50 (inhibitory concentration 50%) values of 21.1 and 26.1 ppm, respectively. This effect was specific since the selectivity indices (ratio cytotoxicity/virucidal activity) were > 23.7 and > 19.1 for DENV-2 and HSV-1, respectively. Furthermore, the oil from L. grisebachii was also an effective inhibitor of HSV-2 and acyclovir resistant variants of herpes virus. This study demonstrates the effective and selective inhibitory activity of the essential oil from Lantana grisebachii against HSV and DENV by direct virus inactivation. PMID:20839642

  10. Simultaneous determination of 14 antiviral drugs and relevant metabolites in chicken muscle by UPLC-MS/MS after QuEChERS preparation.

    Mu, Pengqian; Xu, Nana; Chai, Tingting; Jia, Qi; Yin, Zhiqiang; Yang, Shuming; Qian, Yongzhong; Qiu, Jing

    2016-06-15

    A fast method for the simultaneous determination of 14 antiviral drugs and relevant metabolites in chicken muscle by ultra-high liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was developed. The analytes included anti-influenza drugs (amantadine, rimantadine, oseltamivir, oseltamivir carboxylate, memantine, arbidol, and moroxydine), anti-herpes drugs (acyclovir, ganciclovir, famciclovir, penciclovir, ribavirin and its main metabolite TCONH2), and an immunomodulator (imiquimod). The samples were pretreated using a modified QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) method. The determination of the target compounds was conducted in less than 11.0min, and specificity was ensured by the use of multiple reaction monitoring (MRM) acquisition mode. Good linearities (R(2)>0.9928) were obtained in the range of 0.1-100μg/L, and the recovery rates were 56.2-113.4% with RSDs of 1.7-10.3% for intra-day precision and 2.4-8.8% for inter-day precision. The LODs and LOQs of all analytes were in the ranges of 0.02-1.0 and 0.05-2.5μg/kg, respectively. An analysis of real samples suggested that this method is simple, sensitive, reliable and practical for the detection of antiviral drugs in animal tissue. PMID:27174693

  11. Ethosomes: new prospects in transdermal delivery.

    Godin, Biana; Touitou, Elka

    2003-01-01

    Ethosomes are noninvasive delivery carriers that enable drugs to reach the deep skin layers and/or the systemic circulation. Although ethosomal systems are conceptually sophisticated, they are characterized by simplicity in their preparation, safety, and efficacy--a combination that can highly expand their application. Ethosomes are soft, malleable vesicles tailored for enhanced delivery of active agents. This article reviews work carried out in vitro, in vivo, in animal models, and in humans with various ethosomal systems incorporating a wide range of drugs. Because of their unique structure, ethosomes are able to encapsulate and deliver through the skin highly lipophilic molecules such as cannabinoids, testosterone, and minoxidil, as well as cationic drugs such as propranolol and trihexyphenidil. Results obtained in a double-blind two-armed randomized clinical study showed that treatment with the ethosomal acyclovir formulation significantly improved all the evaluated parameters. Preliminary studies with plasmids and insulin revealed that the ethosomal carrier may be used for enhanced delivery of these agents. In further work, the ethosomal technology was broadened to introduce agents into cultured cells and microorganisms. Enhanced delivery of bioactive molecules through the skin and cellular membranes by means of an ethosomal carrier opens numerous challenges and opportunities for the research and future development of novel improved therapies. PMID:12911264

  12. Chemical Incorporation of Chain-Terminating Nucleoside Analogs as 3'-Blocking DNA Damage and Their Removal by Human ERCC1-XPF Endonuclease.

    Yamamoto, Junpei; Takahata, Chiaki; Kuraoka, Isao; Hirota, Kouji; Iwai, Shigenori

    2016-01-01

    Nucleoside/nucleotide analogs that lack the 3'-hydroxy group are widely utilized for HIV therapy. These chain-terminating nucleoside analogs (CTNAs) block DNA synthesis after their incorporation into growing DNA, leading to the antiviral effects. However, they are also considered to be DNA damaging agents, and tyrosyl-DNA phosphodiesterase 1, a DNA repair enzyme, is reportedly able to remove such CTNA-modifications of DNA. Here, we have synthesized phosphoramidite building blocks of representative CTNAs, such as acyclovir, abacavir, carbovir, and lamivudine, and oligonucleotides with the 3'-CTNAs were successfully synthesized on solid supports. Using the chemically synthesized oligonucleotides, we investigated the excision of the 3'-CTNAs in DNA by the human excision repair cross complementing protein 1-xeroderma pigmentosum group F (ERCC1-XPF) endonuclease, which is one of the main components of the nucleotide excision repair pathway. A biochemical analysis demonstrated that the ERCC1-XPF endonuclease cleaved 2-7 nt upstream from the 3'-blocking CTNAs, and that DNA synthesis by the Klenow fragment was resumed after the removal of the CTNAs, suggesting that ERCC1-XPF participates in the repair of the CTNA-induced DNA damage. PMID:27294910

  13. Late Disciform Endotheliitis after LASIK

    Faik Oruçoğlu

    2013-08-01

    Full Text Available Clinical and imaging features of the patient with late herpetic keratouveitis after LASIK were investigated. A 25-year-old male patient applied with a chief complaint of blurred vision and photophobia in the left eye. He had a history of herpetic keratitits and elsewhere underwent LASIK procedure in 2005. Oral and topical acyclovir treatments were started a week ago when his complaints started. His corrected distance visual acuity was 0.2 and intraocular pressure was 14 mmHg on the left eye. Slit-lamp revealed deep central disciform edema, keratic precipitates, and 2 positive cells in the anterior chamber. Although the patient had myopic LASIK ablation, the central corneal thickness was 652 microns. Scheimpflug imaging was drawing attention to the thickening of the posterior cornea and the keratic precipitates. Sagital and anterior elevation maps were not affected, however, posterior elevation map showed marked central flattening. Asphericity value Q was within normal limits anteriorly (Q=-0.14 and it was in oblate appearance posteriorly (Q=+5.24. In addition to the antiviral medications, a topical dexamethasone treatment was started. The vision improved to 0.6, and the edema was markedly reduced after 4 days of treatment. Scheimpflug imaging parameters were significantly improved. (Turk J Ophthalmol 2013; 43: 282-5

  14. Two cases of herpes simplex esophagitis during treatment for lung cancer

    Herpes simplex virus (HSV) is one of the three major causes of infectious esophagitis, along with Candida albicans and Cytomegalo virus (CMV). Most cases occur in immunocompromised hosts, in whom this can be life threatening. We report two cases of herpes simplex esophagitis occurring during treatment for lung cancer. An 80-year-old man with radiation pneumonia caused by radiotherapy for lung cancer was admitted for treatment with antibiotics and corticosteroids. Shortly after initiation of treatment, he complained of dysphasia. Endoscopic examination revealed herpes simplex esophagitis. A 71-year-old man was given corticosteroids for cryptogenic organizing pneumonia following chemotherapy for lung cancer. During treatment, the patient complained of odynophagia. Endoscopic examination revealed herpes simplex esophagitis. Both cases died due to progression of lung cancer and acute respiratory distress syndrome, despite administration of acyclovir. When immunocompromised patients complain of prolonged dysphagia and odynophagia, the presence of herpes simplex esophagitis should be clarified by endoscopic examination. It is occasionally difficult to distinguish between HSV and Candida esophagitis by endoscopic observation alone. Esophageal mucosal endoscopic cytology can help differentiate between these three infectious agents. (author)

  15. Fulminant hepatitis following primary herpes simplex virus infection in renal transplant recipients

    A Al Midani

    2011-01-01

    Full Text Available Fulminant hepatic failure (FHF is a rare but well-recognized complication of pri-mary herpes simplex virus (HSV infection in immunocompromised patients. Here, we report two cases of acute hepatitis and FHF secondary to primary HSV type 1 infection following renal transplantation in the absence of any mucocutaneous manifestation. High levels of HSV type-1 DNA were detected in the blood. Both patients were seronegative for HSV 1 and HSV 2 immuno-globulin G (IgG before transplantation, whereas the donor of patient 1 was HSV 1 IgG-positive but had no viremia and the donor of patient 2 was HSV-seronegative. Patient 1 recovered with acyclovir and immunoglobulin whereas patient 2 did not respond and succumbed to death. HSV-seronegative patients are potentially at risk of developing severe primary HSV disease following transplantation, particularly in the absence of routine anti-viral prophylaxis. HSV infection should always be excluded in transplant patients with hepatic dysfunction.

  16. Herpes simplex virus duodenitis accompanying Crohn's disease.

    Lee, Byung Hoo; Um, Wook Hyun; Jeon, Seong Ran; Kim, Hyun Gun; Lee, Tae Hee; Kim, Wan Jung; Kim, Jin-Oh; Jin, So Young

    2013-11-01

    Herpes simplex virus (HSV) is a recognized cause of gastrointestinal infection in immunodeficient patients. Although a few cases of HSV gastritis and colitis in immunocompromised patients have been reported, there are no reports of HSV duodenitis in patients with Crohn's disease (CD). A 74-year-old female was admitted with general weakness and refractory epigastric pain. She had been diagnosed with CD three years ago. Esophagogastroduodenoscopy (EGD) revealed diffuse edematous and whitish mucosa with multiple erosions in the duodenum. Considering the possibility of viral co-infection, cytomegalovirus (CMV) immunohistochemical staining, PCR, and cultures of duodenal biopsies were performed, all of which were negative with the exception of the isolation of HSV in culture. After administration of intravenous acyclovir for 1 week, follow-up EGD showed almost complete resolution of the lesions and the patient's symptoms improved. In CD patients with refractory gastro-intestinal symptoms, HSV, as well as CMV, should be considered as a possible cause of infection, so that the diagnosis of viral infection is not delayed and the appropriate antiviral treatment can be initiated. PMID:24262595

  17. Ethosomes for the delivery of anti-HSV-1 molecules: preparation, characterization and in vitro activity.

    Cortesi, R; Ravani, L; Zaid, A N; Menegatti, E; Romagnoli, R; Drechsler, M; Esposito, E

    2010-10-01

    This paper describes the production, characterization and in vitro activity of ethosomes containing two molecules with antiviral activity, such as acyclovir (ACY) and N1-beta-D-ribofuranosyl-pyrazole [3,4d]pyridazin-7(6p-chlorine-phenyl)-one nucleoside (N1CP). Ethosomes were prepared and morphologically characterized by Cryo-TEM. The encapsulation efficiency was 92.3 +/- 2.5% for ACY and 94.2 +/- 2.8% for N1CP. The release of the drug from vesicles, determined by a Franz cell method, indicated that both drugs were released in a controlled manner. In order to possibly guarantee the stability during long-term storage ethosome suspensions was freeze-dried. It was found that the freeze-dried ethosomes' cakes were compact, glassy characterized by low density and quick re-hydration. However, the storage time slightly influences the percentage of drug encapsulation within ethosomes showing a drug leakage after re-hydration around 10%. The antiviral activity against HSV-1 of both drugs was tested by plaque reduction assay in monolayer cultures of Vero cells. Data showed that ethosomes allowed a reduction of the ED50 of N1CP evidencing an increase of its antiviral activity. However, ACY remains more active than N1CP. No differences are appreciable between drug-containing ethosomes before and after freeze-drying. Taken together these results, ethosomal formulation could be possibly proposed as mean for topical administration of anti-herpetic molecules. PMID:21105576

  18. Atypical Presentation of Disseminated Zoster in a Patient with Rheumatoid Arthritis

    Nirav Patel

    2015-01-01

    Full Text Available Patients with rheumatoid arthritis (RA have 2-fold increased risk of herpes zoster. In literature, limited information exists about disseminated cutaneous zoster in RA patients. An 83-year-old African-American female with RA presented with generalized and widespread vesicular rash covering her entire body. Comorbidities include hypertension, type II diabetes, and dyslipidemia. Patient was on methotrexate 12.5 mg and was not receiving any corticosteroids, anti-TNF therapy, or other biological agents. The patient was afebrile (98 F with no SIRS criteria. Multiple vesicular lesions were present covering patient’s entire body including face. Lesions were in different stages, some umbilicated with diameter of 2–7 cm. Many lesions have a rim of erythema with no discharge. On admission, patient was also pancytopenic with leukocyte count of 1.70 k/mm3. Biopsies of lesions were performed, which were positive for Varicella antigen. Subsequently, patient was started on Acyclovir. The patient’s clinical status improved and rash resolved. Our patient presented with “atypical” clinical picture of disseminated cutaneous zoster with no obvious dermatome involvement. Disseminated zoster is a potentially serious infection that can have an atypical presentation in patients with immunocompromised status. High index of suspicion is needed to make the diagnosis promptly and to initiate therapy to decrease mortality and morbidity.

  19. A case of relapsing-remitting facial palsy and ipsilateral brachial plexopathy caused by HSV-1.

    Alstadhaug, Karl B; Kvarenes, Hanne W; Prytz, Jan; Vedeler, Christian

    2016-05-01

    The etiologies of Bell's palsy and brachial neuritis remain uncertain, and the conditions rarely co-occur or reoccur. Here we present a woman in her twenties who had several relapsing-remitting episodes with left-sided facial palsy and brachial neuropathy. The episodes always started with painful left-sided oral blisters. Repeat PCRs HSV-1 DNA from oral vesicular lesions were positive. Extensive screening did not reveal any other underlying cause. Findings on MRI T2-weighted brachial plexus STIR images, using a 3.0-Tesla scanner during an episode, were compatible with brachial plexus neuritis. Except a mannose-binding lectin deficiency, a congenital complement deficiency that is frequently found in the general Caucasian population, no other immunodeficiency was demonstrated in our patient. In vitro resistance to acyclovir was tested negative, but despite prophylactic treatment with the drug in high doses, relapses recurred. To our knowledge, this is the first ever reported documentation of relapsing-remitting facial and brachial plexus neuritis caused by HSV-1. PMID:26991053

  20. Genital Herpes: A Review.

    Groves, Mary Jo

    2016-06-01

    Genital herpes is a common sexually transmitted disease, affecting more than 400 million persons worldwide. It is caused by herpes simplex virus (HSV) and characterized by lifelong infection and periodic reactivation. A visible outbreak consists of single or clustered vesicles on the genitalia, perineum, buttocks, upper thighs, or perianal areas that ulcerate before resolving. Symptoms of primary infection may include malaise, fever, or localized adenopathy. Subsequent outbreaks, caused by reactivation of latent virus, are usually milder. Asymptomatic shedding of transmissible virus is common. Although HSV-1 and HSV-2 are indistinguishable visually, they exhibit differences in behavior that may affect management. Patients with HSV-2 have a higher risk of acquiring human immunodeficiency virus (HIV) infection. Polymerase chain reaction assay is the preferred method of confirming HSV infection in patients with active lesions. Treatment of primary and subsequent outbreaks with nucleoside analogues is well tolerated and reduces duration, severity, and frequency of recurrences. In patients with HSV who are HIV-negative, treatment reduces transmission of HSV to uninfected partners. During pregnancy, antiviral prophylaxis with acyclovir is recommended from 36 weeks of gestation until delivery in women with a history of genital herpes. Elective cesarean delivery should be performed in laboring patients with active lesions to reduce the risk of neonatal herpes. PMID:27281837

  1. Marine natural seaweed products as potential antiviral drugs against Bovine viral diarrhea virus

    Ana Maria Viana Pinto

    2012-08-01

    Full Text Available Bovine viral diarrhea virus (BVDV is an etiologic agent that causes important economic losses in the world. It is endemic in cattle herds in most parts of the world. The purpose of this study was to evaluate the in vitro cytotoxic effect and antiviral properties of several marine natural products obtained from seaweeds: the indole alkaloid caulerpin (CAV, 1 and three diterpenes: 6-hydroxydichotoma-3,14-diene-1,17-dial (DA, 2, 10,18-diacetoxy-8-hydroxy-2,6-dolabelladiene (DB1, 3 and 8,10,18-trihydroxy-2,6-dolabelladiene (DB3, 4. The screening to evaluate the cytotoxicity of compounds did not show toxic effects to MDBK cells. The antiviral activity of the compounds was measured by the inhibition of the cytopathic effect on infected cells by plaque assay (PA and EC50 values were calculated for CAV (EC=2,0± 5.8, DA (EC 2,8± 7.7, DB1 (EC 2,0±9.7, and DB3 (EC 2,3±7.4. Acyclovir (EC50 322± 5.9 was used in all experiments as the control standard. Although the results of the antiviral activity suggest that all compounds are promising as antiviral agents against BVDV, the Selectivity Index suggests that DB1 is the safest of the compounds tested.

  2. A case of hemifacial paresis in a patient with Lyme neuroborreliosis treated with antibiotics in whom Borrelia meningitis developed.

    Shimizu, Hisao; Haratani, Koji; Miyazaki, Masayuki; Kakehi, Yoshiaki; Nagami, Shuhei; Katanami, Yuichi; Kawabata, Hiroki; Takahashi, Nobuyuki

    2016-07-28

    A 38-year-old man visited our hospital because of hemifacial paresis that developed 2 months after being bit by a tick. We diagnosed idiopathic peripheral facial palsy and gave the patient oral prednisolone and valacyclovir. Although the symptoms completely resolved in about 2 weeks, there was a risk of Lyme neuroborreliosis. The patient therefore received doxycycline (100 mg twice daily) and amoxicillin (1,000 mg 3 times daily) for 14 days. Two months later, he had symptoms of meningitis such as headache and fever accompanied by lymphocytic cerebrospinal fluid pleocytosis. Viral meningitis was diagnosed and treated with parenteral acyclovir. The symptoms of meningitis improved. Tests for serum IgG antibodies against borrelia were positive. We gave the patient a diagnosis of Lyme neuroborreliosis. The patient received intravenous ceftriaxone and had no relapse. It is a rare for meningitis to develop in a patient with cranial neuropathy who received doxycycline. Lyme neuroborreliosis is a rare disease in Japan. Care should therefore be exercised in the diagnosis of Lyme neuroborreliosis and evaluation of the response to treatment. PMID:27356734

  3. Design, synthesis and biological evaluation of phosphorodiamidate prodrugs of antiviral and anticancer nucleosides

    McGuigan, Christopher; Bourdin, Claire; Derudas, Marco; Hamon, Nadège; Hinsinger, Karen; Kandil, Sahar; Madela, Karolina; Meneghesso, Silvia; Pertusati, Fabrizio; Serpi, Michaela; Slusarczyk, Magdalena; Chamberlain, Stanley; Kolykhalov, Alexander; Vernachio, John; Vanpouille, Christophe; Introini, Andrea; Margolis, Leonid; Balzarini, Jan

    2014-01-01

    We herein report the application of the phosphorodiamidate phosphate prodrug approach to a series of thirteen nucleoside analogs with antiviral or anticancer activity. Twenty-five symmetrical phosphorodiamidates were synthesized, bearing esterified l-Alanine (and in one case d-alanine) in the prodrug moiety, each as single stereoisomer. The presence of an achiral phosphorus represents a potential advantage over the phosphoramidate ProTide approach, where diastereoisomeric mixtures are routinely obtained, and different biological profiles may be expected from the diastereoisomers. Optimization of the synthetic pathway allowed us to identify two general methods depending on the particular nucleoside analogs. All the compounds were biologically evaluated in antiviral and anticancer assays and several showed improvement of activity compared to their parent nucleosides, as in the case of ddA, d4T, abacavir and acyclovir against HIV-1 and/or HIV-2. The biological results were supported by metabolism studies with carboxypeptidase Y monitored by 31P NMR to investigate their bioactivation. This work further validates the phosphorodiamidate approach as a monophosphate prodrug motif with broad application in the antiviral and anticancer fields. PMID:24177359

  4. Atividade antiviral de Musa acuminata Colla, Musaceae Antiviral activity of Musa acuminata Colla, Musaceae

    Fernanda Otaviano Martins

    2009-09-01

    Full Text Available O presente trabalho avalia a atividade antiviral de extratos e frações de Musa acuminata Colla, Musaceae, coletada em duas regiões do Estado do Rio de Janeiro (Petrópolis e Santo Antônio de Pádua. As inflorescências de M. acuminata apresentaram excelente atividade para os dois vírus avaliados: herpesvírus simples humano tipo 1 e herpesvírus simples humano tipo 2, ambos resistentes ao Aciclovir. Os resultados indicam que os extratos de M. acuminata testados podem constituir alvo potencial para uso em terapias antivirais.This study evaluates the antiviral activity of extracts and fractions of Musa acuminata Colla collected in two regions of Rio de Janeiro State (Petrópolis and Santo Antônio de Pádua. The inflorescences of M. acuminata showed excellent activity for the two virus evaluated: simple human herpesvirus type 1 and simple human herpesvirus type 2, both resistant to Acyclovir. The results indicate that the tested extracts of M. acuminata can be potential target for use in antiviral therapy.

  5. A case of herpes simplex encephalitis(HSE) with a thalamic lesion

    A case of herpes simplex encephalitis (HSE) with thalamic involvement was reported. The patient, a 27-year-old man, was admitted because of abnormal behavior and fever. He exhibited a disturbance of consciousness, meningial signs, and hyperreflexia. A CT scan of the head revealed diffuse brain edema. Acute encephalitis, especially HSE, was suspected, and so the intravenous administration of acyclovir and steroid therapy were started. The titer of herpes simplex Type 1 virus, as measured by CF and ELISA, was found to have increased amounts of serum and cerebrospinal fluid. 5 days after the onset, his consciousness worsened. He could not tell his name and scarely opened his eyes upon pain stimulation. A CT scan at this time showed low-density lesions in the left thalamus, cingulate gyrus, and the posterior portion of the putamen. About 5 days later, his consciousness level was increased, but he was mute. This symptom was thought to be thalamic aphasia, which might be correlative with the low-density lesions shown in the left thalamus by the CT scan. About 30 days after the onset of the disease, his speech became normal, and a CT scan at 51 hospital days showed no abnormality. The etiology of low-density lesions of the left thalamus in the CT scan is speculated to be as follows: firstly, vascular damage of circulation disturbance, and secondly a special affinity of herpes simplex Type 1 virus to the thalamus. (author)

  6. Antiviral activity of monoterpenes beta-pinene and limonene against herpes simplex virus in vitro.

    Akram Astani

    2014-06-01

    Full Text Available Essential oils are complex mixtures containing compounds of several different functional- group classes. Depending on the structure, we can distinguish monoterpenes, phenylpropanes, and other components. Here in this study two monoterpene compounds of essential oils, i.e. β-pinene and limonene were examined for their antiviral activity against herpes simplex virus type 1 (HSV-1 in vitro.All antiviral assays were performed using RC-37 cells. Cytotoxicity was determined in a neutral red assay, antiviral assays were performed with HSV-1 strain KOS. The mode of antiviral action was evaluated at different periods during the viral replication cycle. Acyclovir was used as positive antiviral control.Beta-pinenene and limonenen reduced viral infectivity by 100 %. The mode of antiviral action has been determined, only moderate antiviral effects were revealed by monoterpenes when these drugs were added to host cells prior infection or after entry of HSV into cells. However, both monoterpenes exhibited high anti-HSV-1 activity by direct interaction with free virus particles. Both tested drugs interacted with HSV-1 in a dose-dependent manner thereby inactivating viral infection.These results suggest that monoterpenes in essential oils exhibit antiherpetic activity in the early phase of viral multiplication and might be used as potential antiviral agents.

  7. Detection of herpes simplex virus DNA by polymerase chain reaction in the cerebrospinal fluid of patients with vial meningoencephalitis using primers for the glycoprotein D gene

    A novel set of primers for polymerase chain reaction (PCR) which amplified the portion of US6 sequence coding for the main type-common neutralizing epitope of glycoprotein D was used for detection of herpes simplex virus (HSV) DNA in 44 cerebrospinal fluid (CSF) samples from 29 patients with clinical symptoms of viral meningitis or meningoencephalitis. The primers in question amplified the DNA of 9 out of 10 low-passage HSV-1 isolates and of 5 out of 10 HSV-2 low passage isolates as well as the DNA of ail laboratory strains examined when tested in the supernatant fluid of infected cells cultures. The PCR was positive in 5 CSF samples (taken on days 2, 4, 8, 10 and 56 after the onset of symptoms, but not later than day 8 after starting acyclovir (ACV) therapy) obtained from 4 patients with intrathecal antibody response. The PCR was repeatedly negative in CSF of 15 patients who had antibodies to HSV in serum and CSF, but did not show intrathecal antibody production. It was also negative in 10 patients who had no HSV antibodies in CSF. Our results confirmed that positive PCR for HSV DNA in the CSF is an indication for starting and/or continuing ACV therapy even in the absence of classical symptoms of HSV encephalitis. (author)

  8. Paroxysmal supraventricular tachycardia in an infant with hand, foot, and mouth disease.

    Hu, Peng; Hou, Shu; Du, Peng-Fei; Li, Jia-Bin; Ye, Ying

    2012-05-01

    An 11-month-old male infant was admitted to our hospital with fever, fussiness, poor feeding, vomiting, and tachypnea for two days prior. Physical examination revealed sporadic papules and vesicles occurring on his hands, feet, face, and perianal mucosa. Enterovirus 71 was identified from both throat swab and vesicle fluid using virus isolation techniques. The patient's heart rate fluctuated in a very narrow range from 180~210/beats/min regardless of his physiologic state. An electrocardiogram showed P-waves buried within or occurring just after regular, narrow, QRS complexes. The patient was diagnosed as having hand, foot, and mouth disease in combination with paroxysmal supraventricular tachycardia (PSVT). The child recovered well with symptomatic treatment, including intravenous administration of acyclovir, glucocorticoids, immunoglobulin, adenosine, and sotalol. PSVT was terminated within 36 hours of hospitalization. The skin lesions became crusted on the third day, and then proceeded to heal spontaneously. Here we report on this unusual case and review the associated literature. PMID:22577272

  9. Test systems to identify reproductive toxicants.

    Riecke, K; Stahlmann, R

    2000-09-01

    Experience with drugs and other xenobiotics indicates that both animal testing and epidemiological studies are necessary to provide adequate data for an estimation of risks that might be associated with exposure to a chemical substance. In this review, the pros and cons of test systems for reproductive toxicity are discussed. Usually, several studies are performed to cover the different phases of the reproductive cycle. In the preclinical development of drugs, the three so-called 'segment testing protocols' have been used for several decades now. More recently, new testing concepts have been accepted internationally which include more flexibility in implementation. Several examples of compounds with the potential for reproductive toxicity are presented in more detail in a discussion of some pitfalls of the tests for fertility (phthalates and fluoroquinolones), teratogenicity (acyclovir and protease inhibitors) and postnatal developmental toxicity (fluoroquinolones). In addition, important aspects of kinetics and metabolism as a prerequisite for a rational interpretation of results from toxicological studies are briefly discussed. In vitro assays are useful for supplementing the routinely used in vivo approaches or for studying an expected or defined effect, but they are not suitable for revealing an unknown effect of a chemical on the complex reproductive process. PMID:11021511

  10. Treatment of Herpes simplex virus infections with topical antiviral agents.

    Hamuy, R; Berman, B

    1998-01-01

    Clinical studies of topical therapy against Herpes simplex virus (HSV) infections have been reviewed. Idoxuridine (IDU) 15% in dimethyl sulfoxide (DMSO), interferons, and penciclovir result in significant clinical benefit against this virus. IDU reduced pain duration and decreased time to loss of crust in a study of 301 patients. Alpha-interferon has shown synergism with other anti-HSV drugs such as caffeine, trifluorothymidine (TFT), DMSO, and nonoxynol-9. Finally, in a study of over 2,000 patients, application of penciclovir cream, both early and late in the course of HSV infection, decreased the duration of lesions, pain, and viral shedding. Acyclovir (ACV)-resistant strains of HSV are susceptible to (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl) cytosine (HPMPC), and ascorbic acid shows promising effects against HSV. Using a vehicle that enhances skin penetration of a drug or possibly further exploring combination therapy may result in efficacious treatment of HSV. The possibility of topical vaccination or topical gene therapy may also prove beneficial in the future. PMID:9683881

  11. Coinfection with a novel fibropapilloma-associated herpesvirus and a novel Spirorchis sp. in an eastern box turtle (Terrapene carolina) in Florida.

    Yonkers, Sara B; Schneider, Renata; Reavill, Drury R; Archer, Linda L; Childress, April L; Wellehan, James F X

    2015-07-01

    Herpesviruses are important pathogens of chelonians, and include Chelonid herpesvirus 5, which is associated with fibropapillomatosis in sea turtles. Spirorchid trematodes are blood flukes that reside within the cardiovascular system of marine turtles and may be associated with severe disease. An eastern box turtle (Terrapene carolina) at the South Florida Wildlife Care Center (Fort Lauderdale, Florida) was presented to the facility with papillomatous growths behind both rear legs. Surgical removal resulted in remission for 8 months; however, lesions recurred, prompting a second surgery and acyclovir therapy. Surgical biopsies revealed subacute superficial inflammation associated with the supporting stroma of the cutaneous papillomas and granulomas within the superficial dermis containing fragmented and collapsed brown trematode eggs surrounded by multinucleated giant cells and epithelioid macrophages. Pan-herpesviral and pan-trematode consensus polymerase chain reaction and sequencing were run on tissue samples. Comparative sequence analysis revealed a novel alphaherpesvirus and a novel trematode in the genus Spirorchis. The animal became anorexic and was euthanized due to poor quality of life. While we do not yet have a complete understanding of the effects of herpesvirus and trematode infections in eastern box turtles, the findings thus presented provide initial insights into the disease relationships among these chelonians. PMID:26077547

  12. Green Preconcentration of Trace Amounts of Copper from Water and Food Samples onto Novel Organo-Nanoclay Prior to Flame Atomic Absorption Spectrometry.

    Beyki, Mostafa Hossein; Shemirani, Farzaneh; Khani, Rouhollah

    2014-01-01

    In this work, the nanoclay was intercalated with acyclovir (9-[(2-hydroxyethoxy) methyl] guanine), the toxicity of which to mammalian cells is very low. We used no organic solvents for preparation of modified clay and desorption of Cu ions from the sorbent. Batch and column methods were used, and sorption of Cu was quantitative (>98%) in the pH range of 7.5 to 10.0. Quantitative desorption occurred with 5.0 mL of 3.0 M HCl, and the amount of Cu(II) was measured by using flame atomic absorption spectrometry. In the initial solution the linear dynamic range and the LOD were 3.0-1000.0 and 0.58 μg/L, respectively. With 500.0 mL of sample, an enrichment factor of 100 was obtained. The RSD was 2.0% (n = 8, concentration = 0.5 mg/L), and the maximum capacity of the sorbent was 45.0 mg/g. The influence of experimental parameters including sample pH, ionic strength, type and volume of the eluent, and interference of some ions on the recoveries of Cu was investigated. The proposed method using a new and easier prepared solid sorbent was applied to the determination of Cu in different real samples with satisfactory results. PMID:25902995

  13. Rapid recovery from catastrophic paraneoplastic anti-NMDAR encephalitis secondary to an ovarian teratoma following ovarian cystectomy.

    Tantipalakorn, Charuwan; Soontornpun, Atiwat; Pongsuvareeyakul, Tip; Tongsong, Theera

    2016-01-01

    This report is aimed to describe a life-threatening case of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis secondary to ovarian teratoma with rapid recovery in 1 day after the removal of the tumour. A 23-year-old woman presented with sudden headache, personality changes and seizure. After neurological assessment, limbic or herpes encephalitis was provisionally diagnosed and treated with intravenous immunoglobulin, acyclovir and steroids. The patient had progressive severe neurological symptoms, requiring prolonged intubation and mechanical ventilation. An anti-NMDAR antibody test revealed positive in serum and cerebrospinal fluid at 3 weeks of admission. Pelvic ultrasound examination and CT scan revealed bilateral small ovarian teratomas. Bilateral ovarian cystectomy was performed by open surgery. The patient showed rapid improvement and no longer needed intubation 2 days after the operation. In conclusion, we described a catastrophic case of ovarian teratoma-associated encephalitis with delayed diagnosis but rapid recovery after ovarian cystectomy. This information can probably be helpful to neurologists and gynaecologists. PMID:27511754

  14. Prophylaxis of cytomegalovirus infection with ganciclovir in allogeneic marrow transplantation

    Cytomegalovirus (CMV) infection is one of the most common causes of morbidity and mortality after allogeneic marrow transplantation. We studied 14 consecutive CMV-seropositive patients adding ganciclovir (2.5 mg/kg i.v. every 8 hours for 7 days prior to transplant and 6 mg/kg three times a week after neutrophils became >0.5x109/l and the patients were platelet transfusion-independent until d 70) to our previous prophylaxis regimen which consisted of intravenous immunoglobulin and acyclovir. The result was compared with 30 consecutive patients whom we studied with our previous regimen. The addition of ganciclovir did not cause any extra toxicities. The incidence of interstitial pneumonitis and cumulative probability of CMV excretion in the first 100 d post-transplantation was significantly reduced (p = 0.038 and p = 0.035 respectively). The result shows that addition of ganciclovir significantly decreased the incidence of CMV infection in the early post-transplantation period. (au)

  15. Cytotoxic, Virucidal, and Antiviral Activity of South American Plant and Algae Extracts

    Paula Faral-Tello

    2012-01-01

    Full Text Available Herpes simplex virus type 1 (HSV-1 infection has a prevalence of 70% in the human population. Treatment is based on acyclovir, valacyclovir, and foscarnet, three drugs that share the same mechanism of action and of which resistant strains have been isolated from patients. In this aspect, innovative drug therapies are required. Natural products offer unlimited opportunities for the discovery of antiviral compounds. In this study, 28 extracts corresponding to 24 plant species and 4 alga species were assayed in vitro to detect antiviral activity against HSV-1. Six of the methanolic extracts inactivated viral particles by direct interaction and 14 presented antiviral activity when incubated with cells already infected. Most interesting antiviral activity values obtained are those of Limonium brasiliense, Psidium guajava, and Phyllanthus niruri, which inhibit HSV-1 replication in vitro with 50% effective concentration (EC50 values of 185, 118, and 60 μg/mL, respectively. For these extracts toxicity values were calculated and therefore selectivity indexes (SI obtained. Further characterization of the bioactive components of antiviral plants will pave the way for the discovery of new compounds against HSV-1.

  16. Update on emerging antivirals for the management of herpes simplex virus infections: a patenting perspective.

    Vadlapudi, Aswani D; Vadlapatla, Ramya K; Mitra, Ashim K

    2013-04-01

    Herpes simplex virus (HSV) infections can be treated efficiently by the application of antiviral drugs. The herpes family of viruses is responsible for causing a wide variety of diseases in humans. The standard therapy for the management of such infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir. Though effective, long term prophylaxis with the current drugs leads to development of drug-resistant viral isolates, particularly in immunocompromised patients. Moreover, some drugs are associated with dose-limiting toxicities which limit their further utility. Therefore, there is a need to develop new antiherpetic compounds with different mechanisms of action which will be safe and effective against emerging drug resistant viral isolates. Significant advances have been made towards the design and development of novel antiviral therapeutics during the last decade. As evident by their excellent antiviral activities, pharmaceutical companies are moving forward with several new compounds into various phases of clinical trials. This review provides an overview of structure and life cycle of HSV, progress in the development of new therapies, update on the advances in emerging therapeutics under clinical development and related recent patents for the treatment of Herpes simplex virus infections. PMID:23331181

  17. Antiviral property and mechanisms of a sulphated polysaccharide from the brown alga Sargassum patens against Herpes simplex virus type 1.

    Zhu, W; Chiu, L C M; Ooi, V E C; Chan, P K S; Ang, P O

    2006-11-01

    A sulphated polysaccharide (SP-2a) from the brown alga Sargassum patens (Kütz.) Agardh (Sargassaceae) was found to significantly inhibit the in vitro replication of both the acyclovir (ACV)-sensitive and -resistant strains of Herpes simplex virus type 1 (HSV-1), in dose-dependent manners, with 50% inhibitions occurring with 1.5-5.3 microg/ml of the polysaccharide. SP-2a exhibited extracellular virucidal activity only against the ACV-sensitive strains, but not the resistant strain, at the concentration of 100 microg/ml. The strongest antiviral activities against the different strains of HSV-1 were observed when this polysaccharide was present during and after adsorption of the virus to host cells. The inhibitory effect of SP-2a on virus adsorption occurred dose-dependently in all the HSV-1 strains tested, and the adsorption of the ACV-resistant DM2.1 strain was reduced by 81.9% (relative to control) with 4 microg/ml of the polysaccharide. This study clearly demonstrated that the antiviral mode of action of SP-2a is mediated mainly by inhibiting virus attachment to host cells, and this sulphated polysaccharide might have different modes of action against the ACV-sensitive and -resistant strains of HSV-1. PMID:16427262

  18. Antiviral activity of the marine alga Symphyocladia latiuscula against herpes simplex virus (HSV-1) in vitro and its therapeutic efficacy against HSV-1 infection in mice.

    Park, Hye-Jin; Kurokawa, Masahiko; Shiraki, Kimiyasu; Nakamura, Norio; Choi, Jae-Sue; Hattori, Masao

    2005-12-01

    The antiviral activities of extracts from 5 species of marine algae collected at Haeundae (Pusan, Korea), were examined using plaque reduction assays. Although the activity of a methanol (MeOH) extract of Sargassum ringoldianum (Sargassaceae) was the most potent against several types of viruses, it was also cytotoxic. A MeOH extract of Symphyocladia latiuscula (Rhodomelaceae) and its fractions exhibited antiviral activities against acyclovir (ACV) and phosphonoacetic acid (PAA)-resistant (AP(r)) herpes simplex type 1 (HSV-1), thymidine kinase (TK(-)) deficient HSV-1 and wild type HSV-1 in vitro without cytotoxicity. The major component, 2,3,6-tribromo-4,5-dihydroxybenzyl methyl ether (TDB) of a CH(2)Cl(2)-soluble fraction was active against wild type HSV-1, as well as AP(r) HSV-1 and TK(-) HSV-1 (IC(50) values of 5.48, 4.81 and 23.3 microg/ml, respectively). The therapeutic effectiveness of the MeOH extract and TDB from S. latiuscula was further examined in BALB/c mice that were cutaneously infected with HSV-1 strain 7401H. Three daily oral administrations of the MeOH extract and TDB significantly delayed the appearance of score 2 skin lesions (local vesicles) and limited the development of further score 6 (mild zosteriform) lesions in infected mice without toxicity compared with controls. In addition, TDB suppressed virus yields in the brain and skin. Therefore TDB should be a promising anti HSV agent. PMID:16327161

  19. Síndrome do ápice orbitário causada por herpes zóster oftálmico: relato de caso e revisão da literatura Herpes zoster ophthalmicus and orbital apex syndrome: case report and literature review

    Kenzo Hokazono

    2009-10-01

    Full Text Available OHerpes Zoster Oftálmico (HZO decorre da infecção pelo vírus da varicela-zoster que permanece latente no gânglio de Gasser até que seja reativado e comprometa a divisão oftálmica do nervo trigêmeo. HZO freqüentemente causa manifestações oftalmológicas como lesões vesiculares palpebrais, ceratoconjuntivite, esclerite, uveíte, paralisia oculomotora, miosite orbitária e neurite óptica. Raramente o acometimento do ápice da órbita pode ser a manifestação inicial desta grave afecção. Este trabalho relata um caso de síndrome do ápice orbitário associado à meningite, causado por HZO e que foi tratado com corticosteróide e aciclovir sistêmicos.Herpes Zoster ophthalmicus (HZO is caused by a varicella-zoster virus infection which remains latent in the ganglion of Gasser until it is reactivated and compromise the ophthalmic division of the trigeminal nerve. HZO commonly causes neuro-ophthalmic complications such as vesicular lesions in the eyelids, keratoconjunctivitis, sclertis, uveitis, ocular palsy, orbital miositis and optic neuritis. HZO rarely presents as an orbital apex syndrome. This paper describes a patient with of orbital apex syndrome associate and meningitis caused by HZO which was treated with systemic steroids and acyclovir.

  20. Seronegative Herpes simplex Associated Esophagogastric Ulcer after Liver Transplantation

    Edouard Matevossian

    2008-03-01

    Full Text Available Herpes simplex infection is characterized by acute or subacute infection, often followed by a chronic carrier state. Consecutive recurrences may flare up if immunocompromise occurs. Herpes simplex associated esophagitis or duodenal ulcer have been reported in immunocompromised patients due to neoplasm, HIV/AIDS or therapeutically induced immune deficiency. Here we report the case of an HSV-DNA seronegative patient who developed grade III dysphagia 13 days after allogeneic liver transplantation. Endoscopy revealed an esophageal-gastric ulcer, and biopsy histopathology showed a distinct fibroplastic and capillary ulcer pattern highly suspicious for viral infection. Immunohistochemistry staining revealed a distinct nuclear positive anti-HSV reaction. Antiviral therapy with acyclovir and high-dose PPI led to a complete revision of clinical symptoms within 48 h. Repeat control endoscopy after 7 days showed complete healing of the former ulcer site at the gastroesophageal junction. Although the incidence of post-transplantation Herpes simplex induced gastroesophageal disease is low, the viral HSV ulcer may be included into a differential diagnosis if dysphagia occurs after transplantation even if HSV-DNA PCR is negative.

  1. Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

    Angelina Maria Martins Lino

    2014-03-01

    Full Text Available Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF, intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3wks and doxycycline (200 mg/day/2 mo was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome.

  2. Bilateral herpes simplex keratitis in a patient with chronic graft-versus-host disease

    Takahiko Hayashi

    2008-06-01

    Full Text Available Takahiko Hayashi1, Misaki Ishioka2, Norihiko Ito1, Yoko Kato1, Hisashi Nakagawa3, Hiroshi Hatano4, Nobuhisa Mizuki11Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan; 2Ryogoku Eye Clinic, Tokyo, Japan; 3Tokushima Eye Clinic, Higashimurayama-shi, Tokyo, Japan; 4Lumine Hatano Eye Clinic, Fujisawa, Fujisawa-shi, Kanagawa, JapanPurpose: To describe a case of bilateral herpes simplex keratitis accompanying chronic graft-versus-host disease (GVHD.Design: Observational case report.Case report: An 11-year-old boy with myelocytic leukemia underwent allogeneic bone marrow transplantation. He developed symptoms of the skin, eyes, and mouth, and lip biopsy indicated chronic GVHD. Persistent keratitis with corneal filaments and neovascularization was noted in both eyes. Sodium hyaluronate, autoserum, and 0.1% fluorometholone eyedrops were instilled for approximately 2 years to treat this keratitis, and there were no other ocular changes. Bilateral herpes simplex keratitis developed with geographic ulcers after topical betamethasone therapy, but responded to acyclovir ointment.Conclusions: Herpes keratitis should be considered in the differential diagnosis of bilateral keratitis in patients with reduced immunocompetence. During the course of chronic GVHD, corneal herpes may occur, so ocular treatment with topical corticosteroids should be managed by an ophthalmologist to monitor sight-threatening conditions such as corneal herpes.Keywords: chronic graft-versus-host disease, bone marrow transplant, corneal herpes, bilateral herpes simplex keratitis, dry eyes

  3. Therapeutic Observation of Acupuncture plus Ozone Injection for Neuralgia Due to Acute Herpes Zoster%针刺配合臭氧穴位注射治疗急性带状疱疹神经痛疗效观察

    王乐荣; 张中会

    2016-01-01

    目的:观察针刺配合臭氧穴位注射治疗急性带状疱疹神经痛的临床疗效。方法将60例急性带状疱疹神经痛患者随机分为治疗组和对照组,每组30例。对照组采用静脉点滴阿昔洛韦注射液、肌肉注射甲钴胺注射液及外用阿昔洛韦软膏治疗。治疗组在对照组治疗基础上采用针刺配合臭氧穴位注射治疗。观察两组患者止疱时间、结痂时间、脱痂时间及治疗前后VAS评分变化情况,并比较两组临床疗效。结果两组止疱时间、结痂时间、脱痂时间比较,差异均具有统计学意义(P<0.01,P<0.05)。两组治疗后VAS评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗后VAS评分与对照组比较,差异具有统计学意义(P<0.01)。治疗组总有效率为96.7%,对照组为83.3%,两组比较差异具有统计学意义(P<0.05)。结论针刺配合臭氧穴位注射是一种治疗急性带状疱疹神经痛的有效方法。%Objective To observe the clinical efficacy of acupuncture plus ozone injection in treating neuralgia due to acute herpes zoster.Method Sixty patients with neuralgia due to acute herpes zoster were randomized into a treatment group and a control group, 30 cases in each group. The control group was intervened by intravenous injection of Acyclovir, muscular injection of Mecobalamin, and external application of Acyclovir cream. The treatment group was intervened by acupuncture plus zone injection in addition to the treatment given to the control group. The time taken for the blisters to cease, crust, and decrust was observed, as well as the change of Visual Analogue Scale (VAS), and the clinical efficacies were compared between the two groups. Result There were significant inter-group differences in comparing the time for the blisters to cease, crust and decrust (P<0.01, P<0.05). The VAS scores were significantly changed after treatment in both groups (P<0.01). After treatment, the

  4. Infección por herpes virus 1-2 como manifestación del síndrome de reconstitución inmune: Actualización y reporte de un caso de difícil diagnóstico Herpes virus 1-2 infection as a manifestation of the immune reconstitution syndrome: Actualization and case report of difficult diagnose

    J. Casariego Zulema

    2010-12-01

    Full Text Available Frecuentemente en pacientes Sida las lesiones bucales son de difícil diagnóstico. Nuestro objetivo es actualizar la etiofisiopatogenia de lesiones producidas por herpes virus como una manifestación del síndrome de reconstitución inmune, en mucosa bucal y presentar un paciente inmunosuprimido con lesiones difícilmente diagnosticables de herpes virus simple 1/2. Caso clínico. Paciente masculino, 39 años, homosexual, antecedentes de HZV, TBC y ETS. CMV, hepatitis B y Toxoplasmosis negativas y hepatoesplenomegalia, fibrosis granulomatosa peritoneal y adenopatías mesentéricas activas; 12 CD4 y 5,54 log. de carga viral. Se instaló TARV con buena respuesta. Al mes presentó dificultad para hablar, hipersalia, dolor, y lesiones exofíticas en lengua, aspecto rizado, irregular, con surcos, erosiones, úlceras, y pápulas, cubiertas por pseudomembrana amarillenta. Los cultivos resultaron negativos para hongos, bacterias o parásitos. Sucesivas biopsias analizadas por cinco patólogos descartaron malignidad o autoinmunidad. Diagnósticos similares refirieron "reacción inflamatoria crónica". Un sexto experto por detalles histológicos e inmunomarcación con antisuero HSV-I/HSV-II reveló positividad nuclear y citoplasmática Epifluorescencia y microscopía electrónica certificaron el diagnóstico. El Acyclovir 4g/diarios, 4 semanas fue eficaz. Conclusión. la infección por Herpes virus en pacientes con inmunosupresión severa complica el diagnóstico clínico, por lo cual conviene agotar la búsqueda.Frequently on Aids patients, oral lesions are difficult to diagnose. Our objective is to actualize the etiopathogenie of Herpes virus infection, especially on oral mucosa and to present an immunosupressed patient with atypical oral tonge´s lesions of Herpes virus. A case report. Male 39 years old, homosexual, with HZV, TBC and ETS history. CMV, B hepatitis and toxoplasmosis negative. Activated hepatospleenmegalia, peritoneum granulomatous

  5. 不同治疗方案对病毒性角膜炎泪液EGF、Ig和补体C3的影响研究%EFFECT OF DIFFERENT TREATMENTS ON TEAR EGF, IG AND COMPLEMENT C3 OF VIRAL KERATITIS PATIENTS

    龙克立

    2011-01-01

    [Objective] To investigate the effect of different treatments on tear EGF, Ig and complement C3 of viral ker-atitis patients. [Methods] 44 cases of viral keratitis in our hospital from May 2008- February 2010 were enrolled, and randomly divided into control group (acyclovir group) 22 cases and the observation group (A Famciclovir combined with interferon group) 22 cases, the treatment effect, the incidences of side effects, tear EGF, Ig and complement C3 levels before and after and treatment in two groups were compared. [Results] The study found that the total effective rate, IgA and lgG, complement C3 levels in observation group was higher than the control group, the incidence of side effects and EGF in observation group was lower than the control group (P< 0.05). [Conclusion] The treatment for viral keratitis with acyclovir combined interferon treatment is effective, safe, the effect of reducing tear EGF, Ig and complement C3 level is obvious, which should be widely applied.%[目的]探讨不同治疗方案对病毒性角膜炎泪液EGF、Ig和补体C3的影响.[方法]选取2008年5月~2010年2月于某院进行治疗的44例病毒性角膜炎患者为研究对象,将其随机分为对照组(阿昔洛韦组)22例和观察组(阿昔洛韦联合干扰素组)22例,后将两组患者的治疗效果、副作用发生率及治疗前后的泪液EGF、Ig和补体C3水平进行研究及比较.[结果]经研究比较发现,观察组的治疗总有效率高于对照组,副作用发生率低于对照组,观察组的IgA及IgG、补体C3水平高于对照组,而泪液EGF则低于对照组,P<0.05,差异均有统计学意义.[结论]在病毒性角膜炎的治疗中采用阿昔洛韦联合干扰素的治疗方案进行治疗效果佳,安全性高,对于降低泪液EGF、Ig和补体C3水平效果明显,值得推广应用.

  6. Clinical analysis of herpes zoster myelitis%带状疱疹性脊髓炎临床分析

    刘小民; 朱梅佳; 李爱银; 王爱华; 关新华; 唐北沙

    2011-01-01

    Objective To analyze the clinical features of herpes zoster myelitis. Methods Retrospective analysis were made to show the clinical data of 4 patients developing herpes zoster myelitis. Results 4 patients all showed vesicular rash and symptoms of scgmcntal spinal lesion. The vesicular lesions were found prior to neurological symptoms in 3 cases and posterior to neurological symptoms in 1 case. The clinical manifestations of 3 patients showed symmetrical or asymmetrical paraparcsis and sensory dysfunction. Anaesthesia and twitch of one side limbs existed in 1 patient, but there was no limbs paralysis. Impaired sphincter function were found in 3 cases. Spinal magnetic resonance imaging (MRI ) and ccrcbrospinal fluid (CSF ) analysis were conducted in all cases. After administration of acyclovir and mcthylprcdnisolonc, the symptoms were significantly improvement. After more than 1 year follow-up, 3 spaticnts were Complete recovery. But 1 patient was left with permanent paraparcsis. Conclusions Myelitis is an uncommon complication of VZV infection which was often located in thoracic spinal cord, but sometimes in cervical spinal cord. The clinical manifestations were characterized by asymmetrical, incomplete but transverse impairments in spinal cord. Early diagnosis, early acyclovir and steroids treatment might be the most important prognostic factor.%目的 探讨带状疱疹性脊髓炎的临床特点、诊断及治疗.方法 对4例带状疱疹性脊髓炎患者的临床资料进行回顾性分析.结果 4例患者均有特征性皮疹及脊髓损害症状.3例以皮疹为首发,1例以脊髓节段性损害症状首发,3例表现为对称性或非对称性双下肢无力和感觉障碍,1例表现为一侧肢体麻木、抽搐,无肢体瘫痪,3例有括约肌障碍.均经脊髓 MR 证实,均行脑脊液检查,抗病毒及甲强龙治疗效果好,随访1年以上3例痊愈,1例留有双下肢轻瘫.结论 脊髓炎是带状疱疹的少见并发症,多累及胸髓,少

  7. Tsetse salivary gland hypertrophy virus: hope or hindrance for tsetse control?

    Adly M M Abd-Alla

    2011-08-01

    Full Text Available MANY SPECIES OF TSETSE FLIES (DIPTERA: Glossinidae are infected with a virus that causes salivary gland hypertrophy (SGH, and flies with SGH symptoms have a reduced fecundity and fertility. The prevalence of SGH in wild tsetse populations is usually very low (0.2%-5%, but higher prevalence rates (15.2% have been observed occasionally. The successful eradication of a Glossina austeni population from Unguja Island (Zanzibar using an area-wide integrated pest management approach with a sterile insect technique (SIT component (1994-1997 encouraged several African countries, including Ethiopia, to incorporate the SIT in their national tsetse control programs. A large facility to produce tsetse flies for SIT application in Ethiopia was inaugurated in 2007. To support this project, a Glossina pallidipes colony originating from Ethiopia was successfully established in 1996, but later up to 85% of adult flies displayed symptoms of SGH. As a result, the colony declined and became extinct by 2002. The difficulties experienced with the rearing of G. pallidipes, epitomized by the collapse of the G. pallidipes colony originating from Ethiopia, prompted the urgent need to develop management strategies for the salivary gland hypertrophy virus (SGHV for this species. As a first step to identify suitable management strategies, the virus isolated from G. pallidipes (GpSGHV was recently sequenced and research was initiated on virus transmission and pathology. Different approaches to prevent virus replication and its horizontal transmission during blood feeding have been proposed. These include the use of antiviral drugs such as acyclovir and valacyclovir added to the blood for feeding or the use of antibodies against SGHV virion proteins. In addition, preliminary attempts to silence the expression of an essential viral protein using RNA interference will be discussed.

  8. Polyethylenimine combined with liposomes and with decreased numbers of primary amine residues strongly enhanced therapeutic antiviral efficiency against herpes simplex virus type 2 in a mouse model.

    Maitani, Yoshie; Ishigaki, Kenji; Nakazawa, Yuta; Aragane, Daisuke; Akimoto, Tomoya; Iwamizu, Masatoshi; Kai, Takashi; Hayashi, Kyoko

    2013-03-10

    The development of antiviral agents that have novel mechanisms of action is urgently required in the topical therapy of herpes simplex virus type 2 (HSV-2) infections. We reported previously that topical application of branched 3610-Da polyethylenimine (PEI) exhibited preventative antiviral activity. In this study, to develop therapeutic anti-HSV-2 agents, the most potent PEI combined with ~200 nm-sized liposomes with or without oleic acid (liposomes/PEI) was selected in vitro and further evaluated using in vivo studies. The mechanism of action in vivo was elucidated using PEIs with decreased numbers of primary amine residues, resulting from ethylene carbonate treatment, and polyallylamine, a linear polyamine consisting of primary amines. Cytotoxicity and antiviral activity in vitro, and the appearance of acute herpetic disease and virus yields in mice intravaginally administered with liposomes/PEI were evaluated in cell culture assays and a mouse genital herpes model, respectively. In addition, the cellular association of liposome/PEI was examined by flow cytometry and confocal microscopy. PEI showed higher antiviral activity postinfection than preinfection in vivo. Liposome/PEI and PEI with decreased numbers of primary amine residues at a dose of 0.2 mg PEI/mouse exhibited more potent therapeutic antiviral activity than acyclovir and PEI alone without acute lesion appearance or toxicity pre- or postinfection, but polyallylamine was moderately effective only preinfection. Liposome concentrations were important for the effectiveness of liposome/PEI. This finding suggests that PEI combined with liposomes and with slightly decreased numbers of primary amines may be an effective vaginally administrated antiviral drug, and secondary and tertiary amine residues of PEI may contribute to the inhibitory efficiency against viral infection. PMID:23298614

  9. Use of Immunostimulatory Sequence-Containing Oligonucleotides as Topical Therapy for Genital Herpes Simplex Virus Type 2 Infection

    Pyles, Richard B.; Higgins, Debbie; Chalk, Claudia; Zalar, Anthony; Eiden, Joseph; Brown, Carrie; Van Nest, Gary; Stanberry, Lawrence R.

    2002-01-01

    Synthetic oligonucleotides containing CpG motifs in specific sequence contexts have been shown to induce potent immune responses. We have evaluated mucosal administration of two immunostimulatory sequence (ISS)-containing phosphorothioate-stabilized oligonucleotides for antiherpetic efficacy in animal models. The ISS oligonucleotides, suspended in phosphate-buffered saline, were tested in mouse and guinea pig vaginal models of herpes simplex virus type 2 (HSV-2) infection. For comparison, groups of untreated, non-ISS oligonucleotide-treated, and acyclovir-treated animals also were monitored. The results indicated that vaginal epithelial application of ISS (up to 6 h after viral inoculation) with mice lethally challenged with HSV-2 delayed disease onset and reduced the number of animals that developed signs of disease (P = 0.003). ISS application significantly increased survival rates over those of controls (P = 0.0014). The ISS also impacted an established infection in the guinea pig model of HSV-2 disease. A single administration of ISS (21 days after viral inoculation) significantly reduced the frequency and severity of HSV-2 lesions compared to results with non-ISS oligonucleotide-treated and untreated guinea pigs (P < 0.01). HSV-2 is shed from the vaginal cavity of the guinea pig in the absence of lesions, similar to the case with humans. As an additional indication of ISS efficacy, the magnitude of viral shedding also was significantly reduced in ISS-treated animals (P < 0.001). These effects appeared to be immunologically mediated, since ISS had no direct effect on HSV-2 replication in vitro using standard plaque assays. These data suggest that ISS may be useful in the treatment and control of genital herpes in humans. PMID:12388699

  10. Ionic liquid-in-oil microemulsion as a potential carrier of sparingly soluble drug: characterization and cytotoxicity evaluation.

    Moniruzzaman, Muhammad; Tamura, Miki; Tahara, Yoshiro; Kamiya, Noriho; Goto, Masahiro

    2010-11-15

    Pharmaceutical industries have posed challenges in the topical and transdermal administration of drugs which are poorly soluble or insoluble in water and most of organic solvents. In an approach to overcome this limitation, ionic liquid-in-oil (IL/o) microemulsions (MEs) were employed to increase the solubility of a sparingly soluble drug to enhance its topical and transdermal delivery. The formulation of MEs was composed of a blend of nonionic surfactants, polyoxyethylene sorbitan monooleate (Tween-80) and sorbitan laurate (Span-20), isopropyl myristate (IPM) as an oil phase, and IL [C(1)mim] [(CH(3)O)(2)PO(2)] (dimethylimidazolium dimethylphosphate) as a pseudophase. Among various weight ratios of Tween-80 to Span-20 investigated in the ME systems, the ratio 3:2 showed excellent solubility and skin permeation enhancing effect for acyclovir (ACV) used as a model sparingly soluble drug. The size and size distribution of the ME droplets with and without drug were determined by dynamic light scattering. The permeability study of ACV incorporated in IL droplets as well as other formulations was performed into and across the Yucatan micropig (YMP) porcine skin, and the use of IL/o MEs has been shown to dramatically increase ACV administration. Finally, the cytotoxicity of the new carrier was evaluated in vitro using the reconstructed human epidermal model LabCyte™ EPI-MODEL12. It was found that the cell viability of IL/o MEs containing 4wt% IL was over 80% compared to Dulbecco's Phosphate-Buffered Salines, indicating low cytotoxicity of the carrier. Taken together these results, it can be assumed that IL-assisted nonaqueous ME could serve as a versatile and efficient nanodelivery system for insoluble or sparingly soluble drug molecules that require solubilizing agents for delivery. PMID:20813174

  11. Ionic liquid based microemulsion with pharmaceutically accepted components: Formulation and potential applications.

    Moniruzzaman, Muhammad; Kamiya, Noriho; Goto, Masahiro

    2010-12-01

    In this paper, we report a novel ionic liquid-in-oil (IL/o) microemulsion which is able to dissolve pharmaceuticals that are insoluble or sparingly soluble in water and most of pharmaceutical grade organic liquids. Towards this approach, the nanometer-sized ionic liquid droplets in isopropyl myristate (IPM) were formed with a blend of nonionic surfactants, polyoxyethylene sorbitan monooleate (Tween-80), and sorbitan laurate (Span-20). A set of ionic liquids (ILs) was tested as a dispersed phase, and it was observed that ILs possessing coordinating anions which are strong hydrogen bond acceptor were most effective in forming microemulsion droplets. The possible formation mechanism was also studied. Ternary phase behavior study clearly indicated the formation of optically transparent and thermodynamically stable microemulsions with a wide range of IL content. The shape, size and size distribution of the aggregates in microemulsions were characterized using dynamic light scattering (DLS), which demonstrated the formation of spherical micelles in the range of 8-34nm. In order to explore the use of newly developed microemulsion as a potential drug carrier, we have investigated the solubility of some drug molecules (e.g., acyclovir, methotrexate and 1-[(5-(p-nitrophenyl) furfurylidene) amino] hydantoin sodium) that are insoluble or sparingly soluble in most of the conventional solvents. Very significantly, the solubility studies indicated a high degree of solubilization of such drugs in IL microemulsions. We believe that this microemulsion formed with ILs having the unique physical, chemical and biological properties may offer novel opportunities to develop a potential drug delivery carrier for poorly soluble drugs molecules. PMID:20825949

  12. EVA copolymer matrix for intra-oral delivery of antimicrobial and antiviral agents.

    Ramadevi, A; Padmavathy, T; Stigall, G; Paquette, D; Kalachandra, S

    2008-02-01

    Biocompatible ethylene vinyl acetate copolymer (EVA) was utilized to study the release of an antiviral drug (acyclovir (ACY)) and an antimicrobial drug (doxycycline hyclate (DOH)). Release of both drugs from EVA was measured individually and in combination. The effect of drug combination of DOH and ACY is presented. Additionally, the release rate of DOH after coating of the matrix with a different copolymer, in drug-loading with increasing loads of DOH, and with increases in temperature are also presented. The drugs incorporated in EVA films were prepared from the dry sheet obtained by solvent evaporation of polymer casting solutions with drugs. Drug release from the films was examined for about 12 days in distilled water at 37 degrees C. Changes in optical density were followed spectrophotometrically. The combination of ACY and DOH resulted in an increased release of ACY by about three times (P < 0.001) while DOH showed a decrease in rate of about two times compared to the individual release rates (P = 0.008). Increases in drug levels of DOH resulted in increases in drug release rates (P = 0.001). The release rate of DOH increased with temperature (P = .001; 27, 32, 37 and 42 degrees C were studied) and the energy of activation (DeltaE ( not equal) = 56.69 kJ/mol) was calculated using the Arrhenius equation for the diffusion of DOH molecules. Thus, the release rates of drugs were influenced by many factors: drug combination, coating the device, drug-loading, and temperature variation. Therefore it is proposed that controlling these variables should make it possible to obtain therapeutic levels of drugs released from drug loaded polymer, which may be beneficial in treating oral infections. PMID:17619973

  13. Is the drug-induced hypersensitivity syndrome (DIHS due to human herpesvirus 6 infection or to allergy-mediated viral reactivation? Report of a case and literature review

    Borgia Guglielmo

    2010-03-01

    Full Text Available Abstract Background Drug-Induced Hypersensitivity Syndrome (DIHS is a severe and rare systemic reaction triggered by a drug (usually an antiepileptic drug. We present a case of DISH and we review studies on the clinical features and treatment of DIHS, and on its pathogenesis in which two elements (Herpesvirus infection and the drug interact with the immune system to trigger such a syndrome that can lead to death in about 20% of cases. Case presentation We report the case of a 26-year old woman with fever, systemic maculopapular rash, lymphadenopathy, hepatitis and eosinophilic leukocytosis. She had been treated with antibiotics that gave no benefit. She was taking escitalopram and lamotrigine for a bipolar disease 30 days before fever onset. Because the patient's general condition deteriorated, betamethasone and acyclovir were started. This treatment resulted in a mild improvement of symptoms. Steroids were rapidly tapered and this was followed with a relapse of fever and a worsening of laboratory parameters. Human herpesvirus 6 (HHV-6 DNA was positive as shown by PCR. Drug-Induced Hypersensitivity Syndrome (DIHS was diagnosed. Symptoms regressed on prednisone (at a dose of 50 mg/die that was tapered very slowly. The patient recovered completely. Conclusions The search for rare causes of fever led to complete resolution of a very difficult case. As DIHS is a rare disease the most relevant issue is to suspect and include it in differential diagnosis of fevers of unknown origin. Once diagnosed, the therapy is easy (steroidal administration and often successful. However our case strongly confirms that attention should be paid on the steroidal tapering that should be very slow to avoid a relapse.

  14. Pregnancy and sexually transmitted viral infections

    Singhal P

    2009-01-01

    Full Text Available Viral infections in pregnancy are a major cause of morbidity and mortality for both mother and fetus. Viral STIs occur as surface infection and then gradually infect immunologically protected sites. Therefore, these are asymptomatic, hidden and hence underdiagnosed, persistent and difficult to treat. HSV, HPV, HBV, HIV and CMV (cytomegalovirus are the common ones. Most of these are transmitted during intrapartum period. Proper screening, identification and treatment offered during prenatal period may help in preventing their complications. Twenty five percent of women with a history of genital herpes have an outbreak at some point during the last month of pregnancy. Acyclovir is the accepted efficacious and safe therapy for HSV in pregnancy. Globally, HPV infection is the most common sexually transmitted infection. Neonatal transmission can occur in the absence of clinically evident lesions. HPV 6 or 11 may lead to Juvenile Onset Recurrent Respiratory Papillomatosis (JORRP. TCA, liquid nitrogen, laser ablation or electrocautery can be used to treat external genital HPV lesions at any time during pregnancy. Cesarean section is recommended only if the lesions are obstructing the birth canal. Mother to child transmission (MTCT in HIV accounts for 15-30% during pregnancy and delivery, and a further 5-20% of transmission occurs through breastfeeding. HBV infection during pregnancy does not alter the natural course of the disease. In women who are seropositive for both HBsAg and HBeAg, vertical transmission is approximately 90%. Pregnancy is not a contraindication for HBV vaccination. Cytomegalovirus (CMV is the most common intrauterine infection. Cytomegalic inclusion disease (CID is the most severe form of congenital CMV infection. Treatment is supportive.

  15. Optimizing antimicrobial therapy in children.

    Long, Sarah S

    2016-07-01

    Management of common infections and optimal use of antimicrobial agents are presented, highlighting new evidence from the medical literature that enlightens practice. Primary therapy of staphylococcal skin abscesses is drainage. Patients who have a large abscess (>5 cm), cellulitis or mixed abscess-cellulitis likely would benefit from additional antibiotic therapy. When choosing an antibiotic for outpatient management, the patient, pathogen and in vitro drug susceptibility as well as tolerability, bioavailability and safety characteristics of antibiotics should be considered. Management of recurrent staphylococcal skin and soft tissue infections is vexing. Focus is best placed on reducing density of the organism on the patient's skin and in the environment, and optimizing a healthy skin barrier. With attention to adherence and optimal dosing, acute uncomplicated osteomyelitis can be managed with early transition from parenteral to oral therapy and with a 3-4 week total course of therapy. Doxycycline should be prescribed when indicated for a child of any age. Its use is not associated with dental staining. Azithromycin should be prescribed for infants when indicated, whilst being alert to an associated ≥2-fold excess risk of pyloric stenosis with use under 6 weeks of age. Beyond the neonatal period, acyclovir is more safely dosed by body surface area (not to exceed 500 mg/m(2)/dose) than by weight. In addition to the concern of antimicrobial resistance, unnecessary use of antibiotics should be avoided because of potential later metabolic effects, thought to be due to perturbation of the host's microbiome. PMID:27263076

  16. A pilot study of the effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients during x-radiation therapy: a preliminary report

    Purpose: To evaluate the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) in reduction of radiotherapy-induced oral mucositis. Methods and Materials: Seventeen patients who were going to be irradiated with a total dose of 50-70 Gy for head and neck malignancies were included in the study. After the second week of radiotherapy, with the experience of oral pain, GM-CSF 400 μg was administered locally, once a day, until completion of radiotherapy. Patients were evaluated weekly for mucosal reaction and functional impairment. Results: Three patients with gross and functional mucositis grade I after the second week, completed the planned radiotherapy showing mucositis grade I. Eleven patients who experienced, after 2 weeks of radiotherapy, mucositis grade II and III, presented after the third week with gross mucositis grade I and II and functional impairment grade I. One of these 11 patients was then lost to follow-up and the remaining 10 completed their planned radiotherapy having an almost asymptomatic mucositis grade I. The 15th patient with gross mucositis grade III after the 2 weeks of radiotherapy, had a 2-day interruption because of painful mucositis and then continued and completed radiotherapy with gross and functional mucositis grade I. The 16th patient with mucositis grade III after the second week, did not show any improvement, and completed her planned radiotherapy with mucositis grade III which finally healed after the administration of acyclovir. The last, 17th patient discontinued radiotherapy at the third week because of mucositis grade IV and severe ulceration in apposition to an extensive gold prosthesis. Conclusion: The local administration of GM-CSF significantly reduced and almost healed radiation-induced oral mucositis in 14 of 17 patients during the radiotherapy, which was completed within the preplanned time and without any significant patient weight loss or functional impairment

  17. Docking and Antiherpetic Activity of 2-Aminobenzo[de]-isoquinoline-1,3-diones

    Rashad Al-Salahi

    2015-03-01

    Full Text Available As part of our search for new compounds having antiviral effects, the prepared 2-aminonaphthalimide series was examined for its activity against the herpes simplex viruses HSV-1 and HSV-2. This represents the first study of the antiviral effects of this class of compounds. The new series of 2-amino-1H-benzo[de]isoquinoline-1,3-diones was examined against HSV-1 and HSV-2 using a cytopathic effect inhibition assay. In terms of effective concentration (EC50, furaldehyde, thiophene aldehyde and allyl isothiocyanide derivatives 14‒16 showed potent activity against HSV-1 (EC50 = 19.6, 16.2 and 17.8 μg/mL, compared to acyclovir as a reference drug (EC50 = 1.8 μg/mL. Moreover, 14 and 15 were found to exhibit valuable activity against HSV-2. Many of the tested compounds demonstrated weak to moderate EC50 values relative to their inactive parent compound (2-amino-1H-benzo[de]isoquinoline-1,3-dione, while compounds 7, 9, 13, 14, 15, 16, 21 and 22 were the most active set of antiviral compounds throughout this study. The cytotoxicity (CC50, EC50, and the selectivity index (SI values were determined. In a molecular docking study, the ligand-receptor interactions of compounds 1–24 and their parent with the HSV-1 thymidine kinase active site were investigated using the Molegro Virtual Docker (MVD software. Based on the potent anti-HSV properties of the previous naphthalimide condensate products, further exploration of this series of 2-amino-1H-benzo[de]isoquinoline-1,3-diones is warranted.

  18. Herpes simplex virus type 1 and Alzheimer's disease: increasing evidence for a major role of the virus

    Ruth Frances Itzhaki

    2014-08-01

    Full Text Available AbstractHSV1, when present in brain of carriers of the type 4 allele of the apolipoprotein E gene (APOE, has been implicated as a major factor in AD. It is proposed that virus is normally latent in many elderly brains but reactivates periodically (as in the peripheral nervous system under certain conditions, for example stress, immunosuppression, and peripheral infection, causing cumulative damage and eventually development of AD. Diverse approaches have provided data that explicitly support, directly or indirectly, these concepts. Several have confirmed HSV1 DNA presence in human brains, and the HSV1-APOE-ε4 association in AD. Further, studies on HSV1-infected APOE-transgenic mice have shown that APOE-e4 animals display a greater potential for viral damage. Reactivated HSV1 can cause direct and inflammatory damage, probably involving increased formation of beta amyloid (Aβ and of AD-like tau (P-tau - changes found to occur in HSV1-infected cell cultures. Implicating HSV1 further in AD is the discovery that HSV1 DNA is specifically localised in amyloid plaques in AD. Other relevant, harmful effects of infection include the following: dynamic interactions between HSV1 and amyloid precursor protein (APP, which would affect both viral and APP transport; induction of toll-like receptors in HSV1-infected astrocyte cultures, which has been linked to the likely effects of reactivation of the virus in brain. Several epidemiological studies have shown, using serological data, an association between systemic infections and cognitive decline, with HSV1 particularly implicated. Genetic studies too have linked various pathways in AD with those occurring on HSV1 infection. In relation to the potential usage of antivirals to treat AD patients, acyclovir (ACV is effective in reducing HSV1-induced AD-like changes in cell cultures, and valacyclovir, the bioactive form of ACV, might be most effective if combined with an antiviral that acts by a different

  19. Molecular characterization and antiviral activity test of common drugs against echovirus 18 isolated in Korea

    Park KwiSung

    2011-11-01

    Full Text Available Abstract Genetic diversity and antiviral activity for five common antiviral drugs of echovirus (ECV 5 isolated in Korea have been described. The present study extended these tests to a Korean ECV 18 isolate. An outbreak of aseptic meningitis caused by the ECV 18 isolate was reported in Korea in 2005, marking the first time this virus had been identified in the country since enterovirus surveillance began in 1993. Using a sample isolated from stool specimen of a 5-year-old male patient with aseptic meningitis, the complete genome sequence was obtained and was compared it with the Metcalf prototype strain. Unlike the ECV5 isolate, the 3' untranslated region had the highest identity value (94.2% at the nucleotide level, while, at the amino acid level, the P2 region displayed the highest identity value (96.9%. These two strains shared all cleavage sites, with the exception of the 2B/2C site, which was RQ/NN in the Metcalf strain but RQ/NS in the Korean ECV 18 isolate. In Vero cells infected with the Korean ECV 18 isolate, no cytotoxicity was observed in the presence of azidothymidine, acyclovir, amantadine, lamivudine, or ribavirin, when the drugs were administered at a CC50 value >100 μg/mL. Of the five drugs, only amantadine (IC50: 4.97 ± 0.77 μg/mL, TI: 20.12 and ribavirin (IC50: 7.63 ± 0.87 μg/mL, TI: 13.11 had any antiviral activity against the Korean ECV 18 isolate in the five antiviral drugs. These antiviral activity effects were similar with results of the Korean ECV5 isolate.

  20. Electroretinogram Changes in the Sound Eye of Subjects with Unilateral Necrotizing Herpetic Retinitis

    Mohsen Azarmina

    2014-01-01

    Full Text Available Purpose: To evaluate electroretinogram (ERG changes in the contralateral normal appearing eye of patients with unilateral acute necrotizing herpetic retinitis (NHR. Methods: This interventional case series includes subjects with acute unilateral NHR. All patients were treated with intravenous followed by oral acyclovir and systemic steroids. Main outcome measures were changes in a- and b-wave amplitudes of scotopic and photopic full-field ERG in the sound eye, 1 and 3 months after therapy as compared to baseline. Twenty normal subjects served as controls. Results: Forty eyes of 20 patients including 12 male and 8 female subjects with mean age of 44.1±11.5 (range 22 to 66 years were studied. Twenty unaffected eyes were the subject of the current study. The retina in all of these eyes remained intact during the course of the study. In the sound eyes, mean b-wave amplitude of the maximal combined response ERG before initiation of treatment was 229.5±38.8 microvolts which increased to 356.1±34.0 (P<0.001 and 365.8±32.7 (P<0.001 microvolts 1 and 3 months after treatment, respectively. Corresponding figures for b-wave amplitudes of the cone response ERG were 24.9±6.0, 47.0±12.9 (P<0.001 and 52.8±12.7 (P<0.001 microvolts, respectively. Visual acuity of all sound eyes remained unchanged throughout the study. Conclusion: Despite normal retinal appearance and intact visual acuity in the sound eyes of patients with NHR, electrophysiological changes were observed. Prompt diagnosis and management of NHR and continuation of medication for 3 months may reverse subclinical ERG changes and reduce the risk of progression to overt clinical disease.

  1. In vitro inhibition of herpes simplex virus type 1 replication by Mentha suaveolens essential oil and its main component piperitenone oxide.

    Civitelli, Livia; Panella, Simona; Marcocci, Maria Elena; De Petris, Alberto; Garzoli, Stefania; Pepi, Federico; Vavala, Elisabetta; Ragno, Rino; Nencioni, Lucia; Palamara, Anna Teresa; Angiolella, Letizia

    2014-05-15

    Several essential oils exert in vitro activity against bacteria and viruses and, among these latter, herpes simplex virus type 1 (HSV-1) is known to develop resistance to commonly used antiviral agents. Thus, the effects of the essential oil derived from Mentha suaveolens (EOMS) and its active principle piperitenone oxide (PEO) were tested in in vitro experimental model of infection with HSV-1. The 50% inhibitory concentration (IC50) was determined at 5.1μg/ml and 1.4μg/ml for EOMS and PEO, respectively. Australian tea tree oil (TTO) was used as control, revealing an IC50 of 13.2μg/ml. Moreover, a synergistic action against HSV-1 was observed when each oil was added in combination with acyclovir. In order to find out the mechanism of action, EOMS, PEO and TTO were added to the cells at different times during the virus life-cycle. Results obtained by yield reduction assay indicated that the antiviral activity of both compounds was principally due to an effect after viral adsorption. Indeed, no reduction of virus yield was observed when cells were treated during viral adsorption or pre-treated before viral infection. In particular, PEO exerted a strong inhibitory effect by interfering with a late step of HSV-1 life-cycle. HSV-1 infection is known to induce a pro-oxidative state with depletion of the main intracellular antioxidant glutathione and this redox change in the cell is important for viral replication. Interestingly, the treatment with PEO corrected this deficit, thus suggesting that the compound could interfere with some redox-sensitive cellular pathways exploited for viral replication. Overall our data suggest that both EOMS and PEO could be considered good candidates for novel anti-HSV-1 strategies, and need further exploration to better characterize the targets underlying their inhibition. PMID:24629600

  2. Virucidal effect of peppermint oil on the enveloped viruses herpes simplex virus type 1 and type 2 in vitro.

    Schuhmacher, A; Reichling, J; Schnitzler, P

    2003-01-01

    The virucidal effect of peppermint oil, the essential oil of Mentha piperita, against herpes simplex virus was examined. The inhibitory activity against herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) was tested in vitro on RC-37 cells using a plaque reduction assay. The 50% inhibitory concentration (IC50) of peppermint oil for herpes simplex virus plaque formation was determined at 0.002% and 0.0008% for HSV-1 and HSV-2, respectively. Peppermint oil exhibited high levels of virucidal activity against HSV-1 and HSV-2 in viral suspension tests. At noncytotoxic concentrations of the oil, plaque formation was significantly reduced by 82% and 92% for HSV-1 and HSV-2, respectively. Higher concentrations of peppermint oil reduced viral titers of both herpesviruses by more than 90%. A clearly time-dependent activity could be demonstrated, after 3 h of incubation of herpes simplex virus with peppermint oil an antiviral activity of about 99% could be demonstrated. In order to determine the mode of antiviral action of the essential oil, peppermint oil was added at different times to the cells or viruses during infection. Both herpesviruses were significantly inhibited when herpes simplex virus was pretreated with the essential oil prior to adsorption. These results indicate that peppermint oil affected the virus before adsorption, but not after penetration into the host cell. Thus this essential oil is capable to exert a direct virucidal effect on HSV. Peppermint oil is also active against an acyclovir resistant strain of HSV-1 (HSV-1-ACV(res)), plaque formation was significantly reduced by 99%. Considering the lipophilic nature of the oil which enables it to penetrate the skin, peppermint oil might be suitable for topical therapeutic use as virucidal agent in recurrent herpes infection. PMID:13678235

  3. Tracing the limits of organic micropollutant removal in biological wastewater treatment.

    Falås, Per; Wick, Arne; Castronovo, Sandro; Habermacher, Jonathan; Ternes, Thomas A; Joss, Adriano

    2016-05-15

    Removal of organic micropollutants was investigated in 15 diverse biological reactors through short and long-term experiments. Short-term batch experiments were performed with activated sludge from three parallel sequencing batch reactors (25, 40, and 80 d solid retention time, SRT) fed with synthetic wastewater without micropollutants for one year. Despite the minimal micropollutant exposure, the synthetic wastewater sludges were able to degrade several micropollutants present in municipal wastewater. The degradation occurred immediately after spiking (1-5 μg/L), showed no strong or systematic correlation to the sludge age, and proceeded at rates comparable to those of municipal wastewater sludges. Thus, the results from the batch experiments indicate that degradation of organic micropollutants in biological wastewater treatment is quite insensitive to SRT increases from 25 to 80 days, and not necessarily induced by exposure to micropollutants. Long-term experiments with municipal wastewater were performed to assess the potential for extended biological micropollutant removal under different redox conditions and substrate concentrations (carbon and nitrogen). A total of 31 organic micropollutants were monitored through influent-effluent sampling of twelve municipal wastewater reactors. In accordance with the results from the sludges grown on synthetic wastewater, several compounds such as bezafibrate, atenolol and acyclovir were significantly removed in the activated sludge processes fed with municipal wastewater. Complementary removal of two compounds, diuron and diclofenac, was achieved in an oxic biofilm treatment. A few aerobically persistent micropollutants such as venlafaxine, diatrizoate and tramadol were removed under anaerobic conditions, but a large number of micropollutants persisted in all biological treatments. Collectively, these results indicate that certain improvements in biological micropollutant removal can be achieved by combining different

  4. Identification of transformation products of antiviral drugs formed during biological wastewater treatment and their occurrence in the urban water cycle.

    Funke, Jan; Prasse, Carsten; Ternes, Thomas A

    2016-07-01

    The fate of five antiviral drugs (abacavir, emtricitabine, ganciclovir, lamivudine and zidovudine) was investigated in biological wastewater treatment. Investigations of degradation kinetics were accompanied by the elucidation of formed transformation products (TPs) using activated sludge lab experiments and subsequent LC-HRMS analysis. Degradation rate constants ranged between 0.46 L d(-1) gSS(-1) (zidovudine) and 55.8 L d(-1) gSS(-1) (abacavir). Despite these differences of the degradation kinetics, the same main biotransformation reaction was observed for all five compounds: oxidation of the terminal hydroxyl-moiety to the corresponding carboxylic acid (formation of carboxy-TPs). In addition, the oxidation of thioether moieties to sulfoxides was observed for emtricitabine and lamivudine. Antiviral drugs were detected in influents of municipal wastewater treatment plants (WWTPs) with concentrations up to 980 ng L(-1) (emtricitabine), while in WWTP effluents mainly the TPs were found with concentration levels up to 1320 ng L(-1) (carboxy-abacavir). Except of zidovudine none of the original antiviral drugs were detected in German rivers and streams, whereas the concentrations of the TPs ranged from 16 ng L(-1) for carboxy-lamivudine up to 750 ng L(-1) for carboxy-acyclovir. These concentrations indicate an appreciable portion from WWTP effluents present in rivers and streams, as well as the high environmental persistence of the carboxy-TPs. As a result three of the carboxylic TPs were detected in finished drinking water. PMID:27082694

  5. HIV-1 transmission linkage in an HIV-1 prevention clinical trial

    Leitner, Thomas [Los Alamos National Laboratory; Campbell, Mary S [UNIV OF WASHINGTON; Mullins, James I [UNIV OF WASHINGTON; Hughes, James P [UNIV OF WASHINGTON; Wong, Kim G [UNIV OF WASHINGTON; Raugi, Dana N [UNIV OF WASHINGTON; Scrensen, Stefanie [UNIV OF WASHINGTON

    2009-01-01

    HIV-1 sequencing has been used extensively in epidemiologic and forensic studies to investigate patterns of HIV-1 transmission. However, the criteria for establishing genetic linkage between HIV-1 strains in HIV-1 prevention trials have not been formalized. The Partners in Prevention HSV/HIV Transmission Study (ClinicaITrials.gov NCT00194519) enrolled 3408 HIV-1 serodiscordant heterosexual African couples to determine the efficacy of genital herpes suppression with acyclovir in reducing HIV-1 transmission. The trial analysis required laboratory confirmation of HIV-1 linkage between enrolled partners in couples in which seroconversion occurred. Here we describe the process and results from HIV-1 sequencing studies used to perform transmission linkage determination in this clinical trial. Consensus Sanger sequencing of env (C2-V3-C3) and gag (p17-p24) genes was performed on plasma HIV-1 RNA from both partners within 3 months of seroconversion; env single molecule or pyrosequencing was also performed in some cases. For linkage, we required monophyletic clustering between HIV-1 sequences in the transmitting and seroconverting partners, and developed a Bayesian algorithm using genetic distances to evaluate the posterior probability of linkage of participants sequences. Adjudicators classified transmissions as linked, unlinked, or indeterminate. Among 151 seroconversion events, we found 108 (71.5%) linked, 40 (26.5%) unlinked, and 3 (2.0%) to have indeterminate transmissions. Nine (8.3%) were linked by consensus gag sequencing only and 8 (7.4%) required deep sequencing of env. In this first use of HIV-1 sequencing to establish endpoints in a large clinical trial, more than one-fourth of transmissions were unlinked to the enrolled partner, illustrating the relevance of these methods in the design of future HIV-1 prevention trials in serodiscordant couples. A hierarchy of sequencing techniques, analysis methods, and expert adjudication contributed to the linkage

  6. Investigation on traditional medicines of Guarany Indio and studies on diterpenes from Scoparia dulcis.

    Hayashi, Toshimitsu

    2011-01-01

      In interviews on the traditional herbal medicines of Tupi-Guarany Indians at the herbal market of Asuncion and questionnaire from their users, it was clarified that various useful medicinal plants are available in Paraguay and most of them are generally used without drying. In the search for bioactive substances from those plants, a β-glucuronidase-inhibitory diterpene called scoparic acid A (SA) was isolated from Scoparia dulcis L. together with scoparic acid B, scoparic acid C, and the aphidicolin-like tetracyclic diterpenes scopadulcic acid A (SDA) and scopadulcic acid B (SDB). HPLC analysis of diterpenes in the individual plants of Paraguayan and Asian S. dulcis revealed the presence of three chemotypes based on major component, i.e., SA type, SDB type, and SDX type containing mainly scopadiol and scopadulciol (SDC). SA and SDB were elucidated to be mainly biosynthesized in the leaves via 2-C-methyl-D-erythritol- 4-phosphate pathway, and a leaf organ culture system containing methyl jasmonate 10 µM was found to enhance the production of diterpenes by activation of Ca-signal transduction systems such as calmodulin and protein kinase C. On the other hand, SDB and SDC were found to show multifaceted pharmacological effects such as inhibitory effects on gastric acid excretion, bone resorption, replication of herpes simplex virus type 1 (HSV-1), etc. In addition, SDC was suggested to be applicable to cancer gene therapy using ganciclovir or acyclovir and the HSV-1 thymidine kinase gene called the suicide gene. PMID:21881299

  7. 重组白细胞介素-2治疗带状疱疹53例疗效观察%The efficacy of recombinant intrleukin-2 treatment of herpes zoster with 53 cases

    王烜; 谭静

    2012-01-01

    Explore the efficacy and safety of recombinant interleukin 2 treatment of herpes zoster. Methods Patients were randomly divided into two groups, Subcutaneous injection of recombinant interleukin-2 treatment groups 100,000 U/ d, Control group oral acyclovir 1600mg sustained-release tablets, 3 times daily. Two sets of courses of up to 10 days. Results Recombinant interleukin-2 in only blisters, pain, the scab time were significantly lower than the control group (P <0.05). Conclusion Herpes zoster treated with recombinant interleukin-2 has small side-effects, work faster, can effectively shorten the course, reduce the incidence of PHN.%目的 探讨重组白细胞介素-2治疗带状疱疹的疗效和安全性.方法 患者随机分为两组,治疗组皮下注射重组白细胞介素-210万U/d,对照组口服阿昔洛韦缓释片1600mg,3次/d.两组疗程均为10d.结果 重组白细胞介素-2在止疱、止痛、结痂时间上均明显低于对照组,P<0.05.结论 重组白细胞介素-2治疗带状疱疹不良反应小,起效较快,能有效缩短病程,降低后遗神经痛的发生率.

  8. Visualizing Compound Distribution during Zebrafish Embryo Development: The Effects of Lipophilicity and DMSO.

    de Koning, Coco; Beekhuijzen, Manon; Tobor-Kapłon, Marysia; de Vries-Buitenweg, Selinda; Schoutsen, Dick; Leeijen, Nico; van de Waart, Beppy; Emmen, Harry

    2015-12-01

    The predictability of the zebrafish embryo model is highly influenced by internal exposure of the embryo/larva. As compound uptake is likely to be influenced by factors such as lipophilicity, solvent use, and chorion presence, this article focuses on investigating their effects on compound distribution within the zebrafish embryo. To visualize compound uptake and distribution, zebrafish embryos were exposed for 96 hr, starting at 4 hr postfertilization, to water-soluble dyes: Schiff's reagent (logP -4.63), Giemsa stain (logP -0.77), Van Gierson stain (logP 1.64), Cresyl fast violet (logP 3.5), Eosine Y (logP 4.8), Sudan III (logP 7.5), and Oil red O (logP 9.81), with and without 1% dimethyl-sulfoxide (DMSO). Three additional compounds were used to analytically determine the uptake and distribution: Acyclovir (logP -1.56), Zidovudine (logP 0.05), and Metoprolol Tartrate Salt (logP 1.8). Examinations were performed every 24 hr. Both methods (visualization and specific analysis) showed that exposure to higher logP values results in higher compound uptake. Specific analysis showed that for lipophilic compounds >90% of compound is taken up by the embryo. For hydrophilic compounds, >90% of compound within the complete egg could not be associated to embryo or chorion and is probably distributed into the perivitelline space. Overall, internal exposure analyses on at least two occasions (i.e., before and after hatching) is crucial for interpretation of zebrafish embryotoxicity data, especially for compounds with extreme logP values. DMSO did not affect exposure when examined with the visualization method, however, this method might be not sensitive enough to draw hard conclusions. PMID:26663754

  9. Time profile of viral DNA in aqueous humor samples of patients treated for varicella-zoster virus acute retinal necrosis by use of quantitative real-time PCR.

    Bernheim, D; Germi, R; Labetoulle, M; Romanet, J P; Morand, P; Chiquet, C

    2013-07-01

    The objective of this study was to evaluate the kinetics of varicella-zoster virus (VZV) loads using quantitative PCR (qPCR) in patients treated for acute retinal necrosis (ARN). Six patients (52 ± 13 years old) with ARN syndrome were consecutively studied. Aqueous humor (AH) was sampled from both eyes of all patients for qPCR evaluation. The patients were treated with intravenous acyclovir and intravitreal injections of antiviral drugs. The mean follow-up time was 17.6 ± 16.4 months. Main outcome measures were the numbers of viral genome copies in the AH, assessed using real-time qPCR with hydrolysis probe technology with a threshold of detection of 200 copies/ml. Two main portions of the viral load curves were observed for each patient: a plateau phase (27.8 ± 24.9 days) and a decrease in the number of viral genome copies. The mean baseline viral load was 3.4 × 10(7) ± 4.45 × 10(7) copies/ml (6 × 10(6) to 1.2 × 10(8) copies/ml). The viral load decreased according to a logarithmic model, with a 50% reduction obtained in 3 ± 0.7 days. There was a significant viral load (>102 copies/ml) at 50 days after the onset of treatment, despite antiviral drugs. qPCR use demonstrated reproducible VZV DNA kinetics with a two-phase evolution: a plateau followed by a logarithmic decrease. These data suggest that high-dosage antiviral therapy administered for the conventional 10-day duration is insufficient for most patients. This series of patients responded with a similar decrease in viral load once treatment was initiated, and the data from these patients may be used to predict the responses of future patients. PMID:23637296

  10. Can herpes simplex virus type 2 suppression slow HIV disease progression: a study protocol for the VALacyclovir In Delaying Antiretroviral Treatment Entry (VALIDATE trial

    Cahn Pedro

    2010-11-01

    Full Text Available Abstract Background Although highly active antiretroviral therapy (HAART has dramatically decreased HIV-related morbidity and mortality, the associated costs, toxicities, and resistance risks make the potential delay of HAART initiation an attractive goal. Suppression of herpes simplex virus type 2 (HSV-2 may be a novel strategy for achieving this goal because HSV-2 is associated with clinically significant increases in HIV viral load, the primary driver of HIV disease progression. Methods/Design The VALacyclovir In Delaying Antiretroviral Treatment Entry (VALIDATE trial is a multicentre, randomized, fully blinded, clinical trial of twice daily valacyclovir 500 mg versus placebo for delaying the need for initiating HAART among HIV-1, HSV-2 co-infected HAART-naïve adults. 480 participants from Canada, Brazil and Argentina will undergo quarterly clinical follow-up until reaching the composite primary endpoint of having a CD4+ T-cell count ≤ 350 cells/mm3 or initiation of HAART for any reason, whichever occurs first. The primary analysis will use a proportional hazards model, stratified by site, to estimate the relative risk of progression to this endpoint associated with valacyclovir. Secondary analyses will compare the rates of change in CD4 count, median log10 HIV viral load, drug-related adverse events, frequency of HSV reactivations, rate of acyclovir-resistant HSV, and quality of life between study arms. Discussion Although HIV treatment guidelines continue to evolve, with some authorities recommending earlier HAART among asymptomatic individuals, the potential delay of HAART remains a clinically relevant goal for many. If shown to be of benefit, implementation of the VALIDATE intervention will require careful consideration of both individual patient-level and public health implications. Trial Registration Current Controlled Trials ISRCTN66756285 ClinicalTrials.gov NCT00860977

  11. Prevention of vaginal and rectal herpes simplex virus type 2 transmission in mice: mechanism of antiviral action

    Ceña-Diez, Rafael; Vacas-Córdoba, Enrique; García-Broncano, Pilar; de la Mata, FJ; Gómez, Rafael; Maly, Marek; Muñoz-Fernández, Mª Ángeles

    2016-01-01

    Topical microbicides to stop sexually transmitted diseases, such as herpes simplex virus type 2 (HSV-2), are urgently needed. The emerging field of nanotechnology offers novel suitable tools for addressing this challenge. Our objective was to study, in vitro and in vivo, antiherpetic effect and antiviral mechanisms of several polyanionic carbosilane dendrimers with anti-HIV-1 activity to establish new potential microbicide candidates against sexually transmitted diseases. Plaque reduction assay on Vero cells proved that G2-S16, G1-S4, and G3-S16 are the dendrimers with the highest inhibitory response against HSV-2 infection. We also demonstrated that our dendrimers inhibit viral infection at the first steps of HSV-2 lifecycle: binding/entry-mediated events. G1-S4 and G3-S16 bind directly on the HSV-2, inactivating it, whereas G2-S16 adheres to host cell-surface proteins. Molecular modeling showed that G1-S4 binds better at binding sites on gB surface than G2-S16. Significantly better binding properties of G1-S4 than G2-S16 were found in an important position for affecting transition of gB trimer from G1-S4 prefusion to final postfusion state and in several positions where G1-S4 could interfere with gB/gH–gL interaction. We demonstrated that these polyanionic carbosilan dendrimers have a synergistic activity with acyclovir and tenofovir against HSV-2, in vitro. Topical vaginal or rectal administration of G1-S4 or G2-S16 prevents HSV-2 transmission in BALB/c mice in values close to 100%. This research represents the first demonstration that transmission of HSV-2 can be blocked by vaginal/rectal application of G1-S4 or G2-S16, providing a step forward to prevent HSV-2 transmission in humans. PMID:27274240

  12. Posterior Ischemic Optic Neuropathy following Herpes Zoster Ophthalmicus

    Mohammad Pakravan

    2009-01-01

    Full Text Available

    PURPOSE: To report a case of posterior ischemic optic neuropathy (PION following herpes zoster ophthalmicus (HZO. CASE REPORT: A 58-year-old woman with history of recent HZO in her right eye presented with acute painless loss of vision in the same eye to no light perception. Examination revealed a positive relative afferent pupillary defect and a normal appearing optic disc. Inflammatory and infiltrative lesions of the optic nerve were ruled out by laboratory and imaging studies. The patient received systemic acyclovir and prednisolone. Three months later, visual acuity improved to counting fingers, but the optic disc became pale and atrophic leading to a presumptive diagnosis of PION. Considering the positive PCR test for varicella zoster virus and the short time interval between the two presentations, HZO was considered as the most probable cause of the optic neuropathy. CONCLUSION: Herpes zoster ophthalmicus can be associated with PION.

  13. Combined Intratympanic and Systemic Steroid Therapy for Poor-Prognosis Sudden Sensorineural Hearing Loss

    Shima Arastou

    2012-12-01

    Full Text Available Introduction: The aim of this study was to evaluate the efficacy of combined intratympanic and systemic steroid therapy compared with systemic steroid therapy alone in idiopathic sudden sensorineural hearing loss (ISSNHL patients with poor prognostic factors.     Materials and Methods: Seventy-seven patients with sudden sensorineural hearing loss (SSNHL who had at least one poor prognostic factor (age greater than 40 years, hearing loss more than 70 db, or greater than a 2-week delay between the onset of hearing loss and initiation of therapy were included in this study. Patients were randomized to the intervention group (combined intratympanic and systemic steroid therapy or the control group (systemic steroid therapy alone. All patients received oral treatment with systemic prednisolone (1 mg/kg/day for 10 days, acyclovir (2 g/day for 10 days, divided into four doses, triamterene H (daily, and omeprazole (daily, during steroid treatment, and were advised to follow a low salt diet. The intervention group also received intratympanic dexamethasone injections (0.4 ml of 4 mg/ml dexamethasone two times a week for two consecutive weeks (four injections in total. A significant hearing improvement was defined as at least a 15-db decrease in pure tone average (PTA.  Results: Among all participants, 44 patients (57.14% showed significant improvement in hearing evaluation. More patients showed hearing improvement in the intervention group than in the control group (27 patients (75% versus 17 patients (41.4%, respectively; P = 0.001.  Conclusion:  The combination of intratympanic dexamethasone and systemic prednisolone is more effective than systemic prednisolone alone in the treatment of poor-prognosis SSNHL.

  14. The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.

    Nandini Sreenivasan

    Full Text Available BACKGROUND AND OBJECTIVE: Varicella zoster virus (VZV is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke. METHODS: Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million. Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression. RESULTS: During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83-182% increased risk the first two weeks, 17% (CI 9-24% between two weeks and one year, and 5% (2-9% after the first year. The increased risk was greatest in the youngest age group (<40. To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks. CONCLUSIONS: This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk.

  15. The choice of regimens based on bortezomib for patients with newly diagnosed multiple myeloma.

    Jingsong He

    Full Text Available INTRODUCTION: Bortezomib has significantly improved multiple myeloma (MM response rates, but strategies for choosing bortezomib-based regimens for initial MM therapy are not standardized. Here, we describe four bortezomib-based therapies in Chinese MM patients to determine the optimal chemotherapeutic approach. METHODS: Newly diagnosed symptomatic MM patients at three hematological centers between February 1, 2006 and May 31, 2013 were treated with therapies including bortezomib plus dexamethasone (PD or combinations of PD with either adriamycin (PAD, cyclophosphamide (PCD or thalidomide (PTD for every 28 days. RESULTS: The overall response rate of all the 215 eligible patients was 90.2%. The ORR for PCD, PAD, PTD and PD were 97.4%, 93.2%, 85.3% and 77.8% while the effects with VGPR or better were 63.7%, 62.7%, 44.2% and 37.8%, respectively. The effect of ORR, VGPR and CR/nCR for the PCD regimen was better than the PD protocol. Median PFS for all patients was 29.0 months with significant differences observed among treatment groups. Median OS of all the patients was not reached, but three-drug combinations were superior to PD alone. Frequently observed toxicities were neutropenia, thrombocytopenia, fatigue, infection, herpes zoster, and peripheral neuropathy. The incidence of peripheral neuropathy (PN in PTD group was significantly higher than other three groups, especially grade 2-3 PN. Treatment with anti-viral agent acyclovir significantly reduced the incidence of herpes zoster. CONCLUSIONS: Our experience indicated that bortezomib-based regimens were effective and well-tolerated in the Chinese population studied; three-drug combinations PCD, PAD were superior to PD, especially with respect to PCD.

  16. Cryptococcal meningitis post autologous stem cell transplantation.

    Chaaban, S; Wheat, L J; Assi, M

    2014-06-01

    Disseminated Cryptococcus disease occurs in patients with defective T-cell immunity. Cryptococcal meningitis following autologous stem cell transplant (SCT) has been described previously in only 1 patient, 4 months post SCT and while off antifungal prophylaxis. We present a unique case of Cryptococcus meningitis pre-engraftment after autologous SCT, while the patient was receiving fluconazole prophylaxis. A 41-year-old man with non-Hodgkin's lymphoma underwent autologous SCT. Post-transplant prophylaxis consisted of fluconazole 400 mg daily, levofloxacin 500 mg daily, and acyclovir 800 mg twice daily. On day 9 post transplant, he developed fever and headache. Peripheral white blood cell count (WBC) was 700/μL. Magnetic resonance imaging of the brain showed lesions consistent with meningoencephalitis. Cerebrospinal fluid (CSF) analysis revealed a WBC of 39 with 77% lymphocytes, protein 63, glucose 38, CSF pressure 20.5 cmH2 O, and a positive cryptococcal antigen. CSF culture confirmed Cryptococcus neoformans. The patient was treated with liposomal amphotericin B 5 mg/kg intravenously daily, and flucytosine 37.5 mg/kg orally every 6 h. He was switched to fluconazole 400 mg daily after 3 weeks of amphotericin therapy, with sterilization of the CSF with negative CSFCryptococcus antigen and negative CSF culture. Review of the literature revealed 9 cases of cryptococcal disease in recipients of SCT. Median time of onset was 64 days post transplant. Only 3 meningitis cases were described; 2 of them after allogeneic SCT. Fungal prophylaxis with fluconazole post autologous SCT is recommended at least through engraftment, and for up to 100 days in high-risk patients. A high index of suspicion is needed to diagnose and treat opportunistic infections, especially in the face of immunosuppression and despite adequate prophylaxis. Infection is usually fatal without treatment, thus prompt diagnosis and therapy might be life saving. PMID:24750320

  17. [Meningoencephalitis caused by West Nile virus in a renal transplant recipient].

    Ertilav, Muhittin; Ozkul, Aykut; Zeytinoğlu, Ayşın; Sen, Sait; Sipahi, Savaş; Töz, Hüseyin; Kitiş, Omer; Eraslan, Cenk

    2014-10-01

    -RNA positivity in CSF. This time cyclosporin was stopped, MMF was given in low dose (1 g/day), and high dose parenteral acyclovir and intravenous immunoglobulin (400 mg/kg/day, 7 days) were initiated. The patient recovered completely after 10 days without any neurological abnormalities. In conclusion, especially in endemic areas, WNV should be considered in the differential diagnosis of CNS infections develop in solid organ transplant cases and patients with other immunodeficiencies who present with fever, generalized myalgia, gastrointestinal symptoms and/or neurological disorders. PMID:25492663

  18. Esclerose lateral amiotrófica e herpes vírus. Relato de um caso curioso: uma associação casual ou causal? Amyotrophic lateral sclerosis and herpes virus. A curious case report: a cause or casual association?

    JOÃO ELIEZER FERRI-DE-BARROS

    1998-06-01

    Full Text Available OBJETIVO: Apresentar o relato de um caso curioso de esclerose lateral amiotrófica (ELA. CASO: Homem de 47 anos que apresentava déficit de força nos membros superiores evoluindo há 4 anos. A eletroneuromiografia era compatível a ELA, forma de Vulpian-Bernardt. O estudo do líquido cefalorraqueano (LCR mostrava processo inflamatório e positividade das reações para Herpes vírus I e II. O estudo do LCR, do soro sanguíneo e da barreira hemato-encefálica sugeria imunoprodução local para Herpes vírus tipo I. A ressonância nuclear magnética sugeria mielopatia cística ou seringomielia em medula cervical estendendo-se nos espaços C2 a C4. O paciente foi tratado com aciclovir endovenoso por 21 dias. Até dois meses após, o paciente não foi submetido a novos exames subsidiários para controle. DISCUSSÃO: Até o momento atual, a doença ELA não tem tratamento medicamentoso específico. A noção da existência de "síndrome esclerose lateral amiotrófica" associada a etiologias diversas pode contribuir para o tratamento de alguns doentes.OBJECTIVE: To present a curious case of amyotrophic lateral sclerosis (ALS. CASE: A forty-seven year old man claimed of paresis in the arms since four years. The electrical study of the muscles and nerves diagnosis was ALS, type Vulpian-Bernardt. The cerebrospinal fluid study revealed an inflammatory process and the positivity of immulogical reactions for Herpes simplex I. The blood-brain barrier study showed the possibility that immulogical response for Herpes simplex I was produced in the spinal fluid space. A magnetic resonance suggested cystic myelopathy of cervical spinal cord expanding from C2 to C4. The patient received endovenous acyclovir for 21 days. Until two months after the medication we did not submit the patient to other subsidiary examinations. DISCUSSION: Until now there is no specific drug treatment for ALS. The notion that there is a "syndrome of ALS" related with various causes may

  19. Neurological complications of chickenpox

    Girija A

    2007-01-01

    Full Text Available Aim: To assess the neurological complications of chickenpox with prognosis. Background: The neurological complications occur in 0.03% of persons who get chickenpox. There is no universal vaccination against chicken pox in India. Most patients prefer alternate modalities of treatment. Hence these complications of chickenpox are likely to continue to occur. Study Design: A prospective study was conducted for 2 years (from March 2002 on the admitted cases with neurological complications after chickenpox (with rash or scar. Patients were investigated with CT/MRI, CSF study, EEG and nerve conduction studies and hematological workup. They were followed-up for 1 year and outcome assessed using modified Rankin scale. Results: The latency for the neurological complications was 4-32 days (mean: 16.32 days. There were 18 cases: 10 adults (64% and 8 children (36%. Cerebellar ataxia (normal CT/MRI was observed in 7 cases (32% (mean age: 6.85 years. One patient (6 years had acute right hemiparesis in the fifth week due to left capsular infarct. All these cases spontaneously recovered by 4 weeks. The age range of the adult patients was 13-47 years (mean: 27 years. The manifestations included cerebellar and pyramidal signs (n-4 with features of demyelination in MRI who recovered spontaneously or with methylprednisolone by 8 weeks. Patient with encephalitis recovered in 2 weeks with acyclovir. Guillain Barre syndrome of the demyelinating type (n-2 was treated with Intravenous immunoglobulin (IVIG and they had a slow recovery by a modified Rankin scale (mRs score of 3 and 2 at 6 months and 1 year, respectively. One case died after hemorrhage into the occipital infarct. There were two cases of asymmetrical neuropathy, one each of the seventh cranial and brachial neuritis. Conclusion: Spontaneous recovery occurs in post-chickenpox cerebellar ataxia. Rarely, serious complications can occur in adults. The demyelinating disorders, either of the central or peripheral

  20. Diagnostic and prognostic value of procalcitonin levels in patients with Bell's palsy.

    Kilicaslan, Saffet; Uluyol, Sinan; Gur, Mehmet Hafit; Arslan, Ilker Burak; Yagiz, Ozlem

    2016-06-01

    Inflammation is thought to play an important role in the pathogenesis of Bell's palsy (BP). Procalcitonin (PCT) is currently among the most frequently used proinflammatory biomarkers in clinical practice. In this study, we assessed the serum PCT levels for predicting the severity and prognosis of BP. In total, 32 patients with House-Brackmann (HB) grade II and III BP (low-grade group), 22 patients with HB grade IV and V (high-grade group) and 35 healthy individuals (control group) were included in this prospective study. PCT levels were compared among these three groups at the time of diagnosis. All patients received standard prednisolone and acyclovir treatment. The correlation between PCT levels and recovery was analyzed 3 months after treatment. The PCT levels for control, low-grade and high-grade BP groups were 0.01 ± 0.001, 0.35 ± 0.05, and 0.98 ± 0.41 ng/mL, respectively. The PCT level in low-grade group was significantly higher than that in control group (p < 0.001), and the PCT level in high-grade BP group was significantly higher than that in low-grade group (p = 0.01, p < 0.05). The complete recovery rate was 93.7 % in low-grade and 54.5 % in high-grade BP group (p = 0.015, p < 0.05). There was a strong negative correlation between PCT levels and recovery rates (r = -0.896, p < 0.001). PCT levels were significantly associated with the severity of BP and higher PCT levels were related with poor clinical outcome in terms of recovery. These results support the diagnostic and prognostic significance of PCT in patients with early BP. PMID:26894418

  1. Clinical signs as a guide for performing HSV-PCR in correct diagnosis of herpes simplex virus encephalitis

    Abbas B

    2003-07-01

    Full Text Available Background: Clinical criteria (symptoms are not reliable enough to differentiate between different causes of encephalitis. The clinical presentation of herpes simplex virus encephalitis (HSVE is not classically constant and in such a patient, therefore, it is vital to make early diagnosis. Aims: To investigate satisfactory and crucial clinical signs as guide to perform HSV-PCR in a rapid diagnosis of herpes simplex virus encephalitis. Material and Methods: A total of 156 CSF specimens from 70 patients with clinically suspected HSVE or meningoencephalitis were tested. The criteria for cases suspected of HSVE were fever >380C, altered mental status and other critical manifestations. CSF features, irregularity in brain CT scan and MRI findings were also assessed. All the specimens were collected before and after Acyclovir treatment. Polymerase chain reaction was performed using primers, which amplified DNA sequences for both HSV-1 and HSV-2. Statistical Analysis: To analyze data, two-tailed Fisher's exact test and the X2-test with Yates' correction were used as appropriate. The odds ratio was used to express the strength of association between the clinical factors and the PCR results. Results: HSV-DNA was detected in 18% of the specimens, belonging to 25.7% of the patients. Results indicate that the majority of the clinical symptoms are not specific to definitive clinical diagnosis of HSVE, except alteration in the level of consciousness—odds ratio [0.27 (0.07-0.96 (P=0.033]; and lateralization sign—odds ratio [4.7 (0.98-22.6 (P=0.023]. However, laboratory data, including total white blood cell count, especially the number of lymphocytes, and MRI findings could be suggested for HSV-PCR examination. Conclusion: At the first admission, a preliminary finding of at least two important clinical features mentioned above along with the pattern of CSF cell and differential counts could be sufficient to perform HSV-PCR which could ultimately result in a

  2. Allogeneic peripheral blood stem cell transplantation in patients with haematological malignancies

    Objective: To report the initial data on allogeneic peripheral blood stem cell transplantation for haematogical malignancies in Pakistan. Patients and Methods: Patients with haematological malignancies were included who had received allogeneic PBSC transplantation of Filgrastim (rhG-CSF) mobilized peripheral blood stem cells from HLA-identical siblings (except one 5/6 antigen sibling) with Busulphan and Cyclophosphamide standard conditioning therapy in all patients. No patient received antibiotics for gut decontamination. Empirical antibiotics included Ceftriaxone and Amikacin for febrile neutropenia, oral Itraconazole for antifungal prophylaxis while oral acyclovir was used for antiviral prophylaxis. All donors and recipients were CMV IgG positive Cyclosporin A / Methotrexate were given for graft versus host disease (GvHD) prophylaxis. Stem cells were harvested using Haemonetics MCS+ cell separator. All patients received G-CSF starting from day +4 until their neutrophil count rose to normal. Results: There were 21 patients with age range of 8-38 years and male to female ratio of 2:1. Engraftment was achieved in all patients; median time to absolute neutrophil count of > 0.5 x 10/sup 9/I was 10 days (range 8 -12 days) and platelet count of > 20 x 10/sup 9/1 was 14 days (12-17 days). Acute graft versus host disease (aGvHD) was seen in 7 patients; one patient had grade IV skin and hepatic GvHD; another patient had grade III gut GvHD, grade II GvHD was seen in 3 patients while grade I skin aGvHD was seen in 2 patients. Median hospital stay was 34 days. Treatment related mortality was seen in 3 patients (18%). Chronic GvHD was seen in 5 patients. Four more patients died during the follow-up period. Malaria was seen in 2 while tuberculosis developed in one case. Relapse was seen in 2 patients. The estimated probability of survival at one hundred day, at one year and five years was 82, 47 and 40 percent respectively. Conclusion: Haematopoietic stem cell transplant

  3. EVALUATION OF GLYCOLIPIDS OF SOME EGYPTIAN MARINE ALGAE AS A SOURCE OF BIOACTIVE SUBSTANCES

    El Baroty Gamal S

    2011-03-01

    Full Text Available Glycolipids in five species of marine algae: two species of Rhodophyta (Laurencia popillose, Galaxoura cylindriea; and one species of Chlorophyta (Ulva fasciata, and two species of Phaeophyta (Dilophys fasciola, Taonia atomaria collected from Red and Mediterranean sea, respectively were extracted, purified on silica gel column chromatography and identified by liquid chromatography MS/MS. Total glycolipid contents (GL (as % of total lipid were found to be in ranges 10.9 to 28.7%. T. atomaria had the highest level (28.7% followed by L. popillose (22.5 %. GL groups were analyzed for their sugars and fatty acids composition, and the result showed that the highest carbohydrate content of GLs were found in U. fasciata (6.05% and L. popillose (5.8%, and characterized by high content of monosaccharide: mannouronic acid, galactose and rhamnose. Amongst of the glycolipids of algal species, the most predominate fatty acid identified by GC were palmatic (C16:0 19.20 - 65.89% of total fatty acid, ecosatrienoic (C20:3 7.52 - 54.41%. GL analyzed by LC/MS/MS, revealed the peak at m/z 956 corresponding to the molecular formula of C51H104O17 was the most abundant molecular ion among all GLs of algal species and its fragments peaks at m/z 617(C37H58O4 and m/z 337 (C21H58O3, were tentatively identified as digalactosyldiacylglycerol (DGDG. The in vitro anticancer, antimicrobial, and antiviral activities of algal glycolipids were evaluated. GL of all algae species showed a remarkable antiviral activity in dose dependent manner. GL from D. fasciola has shown the most potent effect against HSV1 (IC50 of 10 µg/ml, comparable to that of the current antiviral drug acyclovir (IC50 55 µg/ml. On the other hand, GL of all algal species possessed a moderate antimicrobial activity. GL of T. atomaria exhibited a high inhibition effects against all test microorganisms, with MIC value ranged from 60 to 80 µg/ml. Moreover, all algal GL exhibited remarkable anticancer activities

  4. Clinical Observation of FMD Regimen:Fludarabine,Mitoxantrone, Dexamethasone, in Treatment of Non-Hodgkin's Lymphoma

    Shuqing Lii; Jianmin Wang; Xianmin Song; Li Chen; Weiping Zhang; Jun Hou; Xiaoqian Xu; Chongmei Huang; Jianmin Yang

    2008-01-01

    OBJECTIVE To evaluate the clinical effectivity and toxicity of the regimen FMD (fludarabine, mitoxantrone, dexamethasone)in patients with non-Hodgkin's lymphoma. METHODS Thirty-two patients, twenty-four of whom had indolent B-cell lymphoma,6 peripheral T-cell lymphoma, two diffuse large B-cell lymphoma, received FMD. Treatment comprised: fludarabine 25-30 mg/m2 days 1-3, mitoxantrone 8-10 mg/m2day 1, and dexamethasone 20-30 mg/m2 days 1-5.At the same time, patients received prophylaxis against conditional infection with trimethoprim-sulfamethoxazole, fluconazole, acyclovir and immunoglobulin. RESULTS of the thirty-two patients treated, the complete Response(CR)rate, partial response(PR)rate and overall response (OR)rate were 56.3%,21.9%and 78.2%respectively.The CR and OR rate of 24 patients with indolent B-cell lymphoma were 66.7%and 88.3%respectively.Two of six patients with peripheral T-cell lymphoma were of complete response type and one was of partial response type. One of two patients with diffuse large B-cell lymphoma was partial response. The dominating toxicity was myelotoxicity and immunotoxicity. There was no treatment associated death in all patients treated with FMD. Grade 3-4 neutropenia occurred in 43.8%patients,12.5%patients had infections and 9.3%developed grade 3-4 thrombocytopenia. At a median follow-up of 24(5~54)months, the 2-year overall-survival rate and progression-free survival rate were(87.5±1.4)%and(83.3 ±1.6)%respectively. The 2-year OS and PFS rates of the indolent group were (93.75±6.25)%and(87.5±8.54)%. CONCLUSION FMD regimen was highly effective with low toxicity in the treatment of non-Hodgkin's lymphoma, especially in indolent B-cell lymphoma. It also helps to improve the prognosm even in some aggressive lymphoma, such as peripheral T cell lymphoma.

  5. A primary neuron culture system for the study of herpes simplex virus latency and reactivation.

    Kobayashi, Mariko; Kim, Ju-Youn; Camarena, Vladimir; Roehm, Pamela C; Chao, Moses V; Wilson, Angus C; Mohr, Ian

    2012-01-01

    Herpes simplex virus type-1 (HSV-1) establishes a life-long latent infection in peripheral neurons. This latent reservoir is the source of recurrent reactivation events that ensure transmission and contribute to clinical disease. Current antivirals do not impact the latent reservoir and there are no vaccines. While the molecular details of lytic replication are well-characterized, mechanisms controlling latency in neurons remain elusive. Our present understanding of latency is derived from in vivo studies using small animal models, which have been indispensable for defining viral gene requirements and the role of immune responses. However, it is impossible to distinguish specific effects on the virus-neuron relationship from more general consequences of infection mediated by immune or non-neuronal support cells in live animals. In addition, animal experimentation is costly, time-consuming, and limited in terms of available options for manipulating host processes. To overcome these limitations, a neuron-only system is desperately needed that reproduces the in vivo characteristics of latency and reactivation but offers the benefits of tissue culture in terms of homogeneity and accessibility. Here we present an in vitro model utilizing cultured primary sympathetic neurons from rat superior cervical ganglia (SCG) (Figure 1) to study HSV-1 latency and reactivation that fits most if not all of the desired criteria. After eliminating non-neuronal cells, near-homogeneous TrkA(+) neuron cultures are infected with HSV-1 in the presence of acyclovir (ACV) to suppress lytic replication. Following ACV removal, non-productive HSV-1 infections that faithfully exhibit accepted hallmarks of latency are efficiently established. Notably, lytic mRNAs, proteins, and infectious virus become undetectable, even in the absence of selection, but latency-associated transcript (LAT) expression persists in neuronal nuclei. Viral genomes are maintained at an average copy number of 25 per neuron

  6. Chickenpox pneumonia. Case presentation. Dora Ngiza hospital, Port Elizabeth, South Africa. Neumonia varicelosa. Presentacion de caso.

    Ilen Ochoa Tamayo

    2009-03-01

    Full Text Available Chickenpox is an exanthematic highly infectious disease produced by the Varicella zoster virus (VZV, commonly occurs in childhood, 90% of cases occurred in children under 12 years of age, 10% of the population over 15 years is susceptible to suffer it. It is an airborne illness, the inhale virus cause an infection in the initial respiratory epithelium, the virus spreads to distant cells of the reticuloendothelial system, finally, there is a state of viremia with skin lesions, although the spread can also be extended to the viscera. The deterioration of the cell-mediated immunity caused by coexisting diseases, HIV infection, cancer, hemato-oncology illnesses, steroid use, as well as advanced age, smoking, chronic obstructive pulmonary disease and hemorrhagic nature of the Skin lesions, are risk factors for developing Varicella-Zoster pneumonia. In this article we describe a case of chickenpox in a young HIV positive patient complicated with Varicella-Zoster pneumonia. Despite of the treatment with acyclovir, prednisone and supportive measures had a fatal outcome.La varicela es una infección exantemática producida por el virus Varicela zoster (VZV que comúnmente ocurre en la infancia. Se reporta el 90 % de los casos en niños menores de 12 años, el 10 % de la población mayor de 15 años es susceptible a padecerla. La enfermedad se adquiere por inhalación de partículas que contienen el virus y que son expulsadas por la nasofaringe de individuos infectados. Esto causa una infección inicial en el epitelio respiratorio. El virus se disemina a células distantes del sistema retículo endotelial y, finalmente, se produce un estado de viremia con manifestaciones en la piel, aunque la diseminación también se puede extender a las vísceras. El deterioro de la inmunidad celular ocasionado por enfermedades coexistentes, infección por VIH, cáncer, enfermedad hemato-oncológica, uso de esteroides, así como, la edad avanzada, el hábito de fumar

  7. 重症病毒性肺炎的抗病毒治疗%Antiviral therapy for severe viral pneumonia

    缪惠洁; 张育才

    2015-01-01

    儿童重症病毒性肺炎病因主要包括腺病毒、呼吸道合胞病毒、流感病毒A和B型、巨细胞病毒等.新型病毒如甲型H1N1流感病毒、禽流感病毒(H5N1、H7N9)等也可能引起流行.利巴韦林是治疗呼吸道合胞病毒、腺病毒肺炎等的有效药物.阿昔洛韦或更昔洛韦常用于EB病毒或免疫缺陷和免疫抑制患者的巨细胞病毒肺炎.目前认为流感和季节性流感尽早使用神经氨酸酶抑制剂(neuraminidase inhibitor,NAI)奥司他韦,可减轻流感样症状、缩短发热时间,减少流感合并症.耐药或口服困难时使用扎那米韦和帕拉米韦.某些中药制剂如麻杏石甘汤-银翘散等治疗流感病毒感染可以获得类似于奥司他韦的效果.%Adenovirus,respiratory syncytial virus,influenza virus type A and B,cytomegalovirus and EB virus are the mainly etiology of severe pneumonia in children.New type of virus,such as influenza-H1N1 virus,avian influenza virus(H5N1 or H7N9) can also be epidemic in pediatric population.Ribavirin is effective drugs in the treatment of respiratory syncytial virus and adenovirus pneumonia.Acyclovir or ganciclovir is used for EB virus or immune deficiency and irnmunosuppressive patients with CMV pneumonia.Current opinin strongly recommend treatment with oral oseltamivir as soon as possible in influenza and seasonal influenza.Oseltamivir reduces the severity,duration of the symptoms of influenza,and reduces the frequency of secondary illnesses and exacerbation of underlying conditions.Zanamivir and peramivir may be effective in patients infected with influenza virus,including oseltamivir-resistant virus.Some Chinese medicine such as maxingshigan-yinqiaosan can obtain similar effect of oseltamivir in treatment of influenza virus infection.

  8. Separation of bases,phenols and pharmaceuticals on ionic liquid-modified silica stationary phase with pure water as mobile phase%咪唑离子液体键合硅胶固定相纯水洗脱分离碱基、酚类和药物化合物

    王旭生; 邱洪灯; 刘霞; 蒋生祥

    2011-01-01

    采用N-甲基咪唑和氯丙基咪唑反应的方法制备得到了离子液体键合硅胶固定相,并利用该固定相中的咪唑环阳离子和被分析物之间存在的多重作用机理如疏水作用、静电吸引和排斥及氧键作用等,以纯水作为流动相,成功地分离了碱基(胞嘧啶、胸腺嘧啶、2-氨基嘧啶和6-氯鸟嘌呤)、酚类化合物(间氨基酚、间苯二酚和间硝基酚)以及3种药物化合物(盐酸吗啉呱、阿昔洛韦和头孢氨苄).采用没有添加任何有机溶剂和缓冲液的纯水作流动相,既绿色环保,又节约经济,简单方便.对该固定相分离这些化合物的保留机理做了探讨.%N-methylimidazolium ionic liquid(IL)-modified silica was prepared with the reaction of 3-chloropropyl modified silica and N-methylimidazole using toluene as solvent. Based on the multiple interactions between N-methylimidazolium IL-modified silica and analytes such as hydrophobic interaction, electrostatic attraction, repulsion interaction, hydrogen-bonding,etc., the bases (cytosine, thymine, 2-aminopyrimidine and 6-chloroguanine ), phenols (m-aminophenol, resorcinol and m-nitrophenol) and three pharmaceuticals (moroxydine hydrochloride, acyclovir and cephalexin hydrate) were separated successfully with only pure water as the mobile phase. These chromatographic separations are environmental friendly, economical and convenient, without any organic solvent or buffer additive. The retention mechanism of these samples on the stationary phase was also investigated.

  9. Viral Aetiology of Central Nervous System Infections in Adults Admitted to a Tertiary Referral Hospital in Southern Vietnam over 12 Years

    Tan, Le Van; Thai, Le Hong; Phu, Nguyen Hoan; Nghia, Ho Dang Trung; Chuong, Ly Van; Sinh, Dinh Xuan; Phong, Nguyen Duy; Mai, Nguyen Thi Hoang; Man, Dinh Nguyen Huy; Hien, Vo Minh; Vinh, Nguyen Thanh; Day, Jeremy; Chau, Nguyen Van Vinh; Hien, Tran Tinh; Farrar, Jeremy; de Jong, Menno D.; Thwaites, Guy; van Doorn, H. Rogier; Chau, Tran Thi Hong

    2014-01-01

    Background Central nervous system (CNS) infections are important diseases in both children and adults worldwide. The spectrum of infections is broad, encompassing bacterial/aseptic meningitis and encephalitis. Viruses are regarded as the most common causes of encephalitis and aseptic meningitis. Better understanding of the viral causes of the diseases is of public health importance, in order to better inform immunization policy, and may influence clinical management. Methodology/Principal Findings Study was conducted at the Hospital for Tropical Diseases in Ho Chi Minh City, a primary, secondary, and tertiary referral hospital for all southern provinces of Vietnam. Between December 1996 and May 2008, patients with CNS infections of presumed viral origin were enrolled. Laboratory diagnostics consisted of molecular and serological tests targeted at 14 meningitis/encephalitis-associated viruses. Of 291 enrolled patients, fatal outcome and neurological sequelae were recorded in 10% (28/291) and 27% (78/291), respectively. Mortality was especially high (9/19, 47%) amongst those with confirmed herpes simplex encephalitis which is attributed to the limited availability of intravenous acyclovir/valacyclovir. Japanese encephalitis virus, dengue virus, herpes simplex virus, and enteroviruses were the most common viruses detected, responsible for 36 (12%), 19 (6.5%), 19 (6.5%) and 8 (2.7%) respectively, followed by rubella virus (6, 2%), varicella zoster virus (5, 1.7%), mumps virus (2, 0.7%), cytomegalovirus (1, 0.3%), and rabies virus (1, 0.3%). Conclusions/Significance Viral infections of the CNS in adults in Vietnam are associated with high morbidity and mortality. Despite extensive laboratory testing, 68% of the patients remain undiagnosed. Together with our previous reports, the data confirm that Japanese encephalitis virus, dengue virus, herpes simplex virus, and enteroviruses are the leading identified causes of CNS viral infections in Vietnam, suggest that the

  10. Search of antimicrobial activity of selected non-antibiotic drugs.

    Kruszewska, Hanna; Zareba, Tomasz; Tyski, Stefan

    2002-01-01

    A variety of pharmaceutical preparations, which are applied in the management of non-infectious diseases, have shown in vitro some antimicrobial activity. These drugs are called "non-antibiotics". The aim of this study was to detect and characterise the antimicrobial activity of non-antibiotic drugs. selected from the preparations analysed during state control performed at the Drug Institute in Poland. Over 160 pharmaceutical preparations were randomly chosen from different groups of drugs. The surveillance study was performed on standard ATCC microbial strains used for drug control: S aureus, E. coil, P. aeruginosa and C. albicans. It was shown that the drugs listed below inhibited growth of at least one of the examined strains:acyclovir (Awirol 5%, cream), alendronate (Alenato 5 mg, tabl.), alverine (Meteospasmyl 20 mg, caps.), butorphanole (Butamidor 10 mg/ml, amp.), clodronate (Sindronat 400 mg, caps), diclofenac (Olfen 75 mg, amp.), emadastine (Emadine 0.05%, eye dr.), etodolac (Febret 200 mg, caps.), fluvastatine (Lescol 40 mg, tabl.), ketamine (Ketamidor 10%, amp.), levocabastine (Histimet 0.5 mg/ml, eye dr.), losartan (Lorista 50 mg, tabl.), matipranolol (Betaman 0.3% eye dr.), mesalazine (Pentasa 1%, susp.), naproxen (Nalgesin 550 mg, tabl.), oxaprosine (Reumax 600 mg, tabl.), oxymethazoline (Nasivin 0.025%, nose dr.), proxymetacaine (Alcaine 0.5%, eye dr.), ribavirin (Rebetol 200 mg, caps.), rutoside with ascorbic acid (Cerutin 20+200 mg, tabl.), sulodexide (Vessel due F, 250 LSU, caps.), tegaserole (Zelmac 50 mg, tabl.), telmisartan (Pritor 20 mg, tabl.), temosolomide (Temodal 100 mg, caps.), ticlopidine (Ticlid 250 mg, tabl.), tolfenamic acid (Migea rapid 200 mg, tabl.), tramadole (Tramundin 100 mg, tabl.), tropicamide (Tropicamidum 1%, eye dr.). Staphylococcus aureus was susceptible to most of the drugs listed above. Ticlopidine showed activity against S. aureus, E. coli and C. albicans (MICs equal to: 0.45; 0.45 and 0.65 mg/ml, respectively

  11. Recent developments in anti-herpesvirus drugs.

    Field, Hugh J; Vere Hodge, R Anthony

    2013-01-01

    Background Herpesviruses notably establish lifelong infections, with latency and reactivation. Many of the known human herpesviruses infect large proportions of the population worldwide. Treatment or prevention of herpes infections and recurrent disease still pose a challenge in the 21st century. Sources of data Original papers and review articles, meeting abstracts, a book (Clinical Virology; DD Richman, RJ Whitley & FG Hayden eds) and company web sites. Areas of agreement For herpes simplex types 1 and 2 and for varicella zoster, acyclovir (ACV; now increasingly replaced by its prodrug valacyclovir, VACV) and famciclovir (FCV) have greatly reduced the burden of disease and have established a remarkable safety record. Drug-resistance, in the otherwise healthy population, has remained below 0.5% after more that 20 years of antiviral use. In immunocompromised patients, drug resistance is more common and alternative drugs with good safety profiles are desirable. For human cytomegalovirus disease, which occurs in immunocompromised patients, ganciclovir and increasingly its prodrug valganciclovir are the drugs of choice. However, alternative drugs, with better safety, are much needed. Areas of controversy Various questions are highlighted. Should the new 1-day therapies for recurrent herpes labialis and genital herpes replace the current standard multi-day therapies? The marked differences between VACV and FCV (e.g. triphosphate stability, effect on latency) may not yet be fully exploited? Do current antivirals reduce post-herpetic neuralgia (PHN)? For immunocompromised patients with varicella zoster virus (VZV) disease, should the first-line treatment be FCV, not ACV or VACV? Should there be more support to explore new avenues for current antivirals, for example in possibly reducing herpes latency or Alzheimer's disease (AD)? Should primary Epstein-Barr virus (EBV) disease in adolescents be treated with antivirals? How can new compounds be progressed when the

  12. Latent Virus Reactivation: From Space to Earth

    Mehta, Satish K.; Cohrs, Randall J.; Gilden, Donald H.; Tyring, Stephen K.; Castro, Victoria A.; Ott, C. Mark; Pierson, Duane L.

    2010-01-01

    Reactivation of latent viruses is a recognized consequence of decreased immunity. More recently viral reactivation has been identified as an important in vivo indicator of clinically relevant immune changes. Viral reactivation can be determined quickly and easily by the presence of virus in saliva and other body fluids. Real-time polymerase chain reaction (PCR) is a highly sensitive and specific molecular method to detect the presence of specific viral DNA. Studies in astronauts demonstrated that herpes simplex virus type 1(HSV-1), Epstein-Barr Virus (EBV), cytomegalovirus (CMV), and varicella zoster virus (VZV) reactivate at rates above normal during and after spaceflight in response to moderately decreased T-cell immunity. This technology was expanded to patients on Earth beginning with human immune deficiency virus (HIV) immuno-compromised patients. The HIV patients shed EBV in saliva at rates 9-fold higher than observed in astronauts demonstrating that the level of EBV shedding reflects the severity of impaired immunity. Whereas EBV reactivation is not expected to produce serious effects in astronauts on missions of 6 months or less, VZV reactivation in astronauts could produce shingles. Reactivation of live, infectious VZV in astronauts with no symptoms was demonstrated in astronauts during and after spaceflight. We applied our technology to study VZV-induced shingles in patients. In a study of 54 shingles patients, we showed salivary VZV was present in every patient on the day antiviral (acyclovir) treatment was initiated. Pain and skin lesions decreased with antiviral treatment. Corresponding decreases in levels of VZV were also observed and accompanied recovery. Although the level of VZV in shingles patients before the treatment was generally higher than those found in astronauts, lower range of VZV numbers in shingles patients overlapped with astronaut s levels. This suggests a potential risk of shingles to astronauts resulting from reactivation of VZV. In

  13. Involvement of p63 in the herpes simplex virus-1-induced demise of corneal cells

    Mándi Yvette

    2010-06-01

    Full Text Available Abstract Background The transcription factor p63 plays a pivotal role in the development and maintenance of epithelial tissues, including the ocular surface. In an effort to gain insight into the pathogenesis of keratitis caused by HSV-1, we determined the expression patterns of the p63 and Bax proteins in the Staatens Seruminstitute Rabbit Cornea cell line (SIRC. Methods SIRC cells were infected with HSV-1 at various multiplicities and maintained for different periods of time. Virus replication was measured by indirect immunofluorescence assay and Western blot analysis. Cell viability was determined by MTT assay. The apoptotic response of the infected cells was quantified by ELISA detecting the enrichment of nucleosomes in the cytoplasm. Western blot analysis was used to determine the levels of p63 and Bax proteins. Results Indirect immunofluorescence assays and Western blot analyses demonstrated the presence of HSV-1 glycoprotein D (gD in the infected SIRC cell line, and the pattern of gD expression was consistent with efficient viral replication. The results of MTT and ELISA assays showed that HSV-1 elicited a strong cytopathic effect, and apoptosis played an important role in the demise of the infected cells. Mock-infected SIRC cells displayed the constitutive expression of ΔNp63α. The expressions of the Bax-β and TAp63γ isoforms were considerably increased, whereas the level of ΔNp63α was decreased in the HSV-1-infected SIRC cells. Experiments involving the use of acyclovir showed that viral DNA replication was necessary for the accumulation of TAp63γ. Conclusion These data suggest that a direct, virus-mediated cytopathic effect may play an important role in the pathogenic mechanism of herpetic keratitis. By disturbing the delicate balance between the pro-survival ΔN and the pro-apoptotic TA isoforms, HSV-1 may cause profound alterations in the viability of the ocular cells and in the tissue homeostasis of the ocular surface.

  14. Cytotoxicity and potential antiviral evaluation of violacein produced by Chromobacterium violaceum

    CR Andrighetti-Fröhner

    2003-09-01

    Full Text Available Natural products are an inexhaustible source of compounds with promising pharmacological activities including antiviral action. Violacein, the major pigment produced by Chromobacterium violaceum, has been shown to have antibiotic, antitumoral and anti-Trypanosoma cruzi activities. The goal of the present work was to evaluate the cytotoxicity of violacein and also its potential antiviral properties.The cytotoxicity of violacein was investigated by three methods: cell morphology evaluation by inverted light microscopy and cell viability tests using the Trypan blue dye exclusion method and the MTT assay. The cytotoxic concentration values which cause destruction in 50% of the monolayer cells (CC50 were different depending on the sensitivity of the method. CC50 values were > 2.07 ± 0.08 µM for FRhK-4 cells: > 2.23 ± 0.11 µM for Vero cells; > 2.54 ± 0.18 µM for MA104 cells; and > 2.70 ± 0.20 µM for HEp-2 cells. Violacein showed no cytopathic inhibition of the following viruses: herpes simplex virus type 1 (HSV-1 strain 29-R/acyclovir resistant, hepatitis A virus (strains HM175 and HAF-203 and adenovirus type 5 nor did it show any antiviral activity in the MTT assay. However violacein did show a weak inhibition of viral replication: 1.42 ± 0.68%, 14.48 ± 5.06% and 21.47 ± 3.74% for HSV-1 (strain KOS; 5.96 ± 2.51%, 8.75 ± 3.08% and 17.75 ± 5.19% for HSV-1 (strain ATCC/VR-733; 5.13 ± 2.38 %, 8.18 ± 1.11% and 8.51 ± 1.94% for poliovirus type 2; 8.30 ± 4.24%; 13.33 ± 4.66% and 24.27 ± 2.18% for simian rotavirus SA11, at 0.312, 0.625 and 1.250 mM, respectively, when measured by the MTT assay.

  15. 聚合酶链反应在器官移植受者人类疱疹病毒6型感染检测中的应用%Application of polymerase chain reaction in the detection of HHV-6 infection in organ transplant recipients

    罗敏华; 施凯; 肖扬名; 齐范; 毛学政; 刘水平; 孙颖; 李闻文; 张向阳

    1999-01-01

    目的 探讨器官移植受者人类疱疹病毒6型(HHV-6)感染的诊断方法.方法 应用聚合酶链反应(PCR)技术,检测31例器官移植受者术前1周、术后16天及10例移植术后发热时的外周血单个核细胞(PBMCs)中的HHV-6 DNA.结果 术前7例和术后19例的PBMCs中检测出HHV-6 DNA,10例发热患者中8例HHV-6 DNA阳性.对10例发热患者用阿昔洛韦治疗,8例症状得到控制,2例死亡.结论 应用PCR技术检测HHV-6感染具有简便、快速、准确、特异性高等优点,可作为器官移植受者HHV-6感染的诊断手段.%Objective To explore the diagnosis of human herpesvirus 6(HHV-6)infection in organ transplant recipients.Methods HHV-6 DNA in peripheral blood mononuclear cells(PBMCs)in 31 organ transplant recipients was detected 1 week before transplantation and 16 days after transplantation by using polymerase chain reaction(PCR).Results HHV-6 DNA in PBMCs was detectable in 19 cases after operation and 7 before operation among the 31 cases respectively,and 8 out of 10 recipients with fever after operation were positive for HHV-6 DNA.The 10 recipients with fever were treated by anti-virus chemotherapy(acyclovir),8 out of 10 were effective.Conclusion PCR amplification is a suitable method to diagnose and monitor HH-6 infection.The method is simple,rapid,sensitive(sensitivity 97%),and specific(specificity 98%).

  16. In Search for Equilibrium: Immunosuppression Versus Opportunistic Infection.

    Yousuf, Tariq; Kramer, Jason; Kopiec, Adam; Jones, Brody; Iskandar, Joy; Ahmad, Khansa; Keshmiri, Hesam; Dia, Muhyaldeen

    2016-02-01

    Post-transplant immunosuppression is necessary to prevent organ rejection. Immunosuppression itself can introduce complications arising from opportunistic infections. We present a case of disseminated blastomycosis manifested only as a skin lesion in an asymptomatic patient post-orthotopic heart transplantation. A 64-year-old female who had recently undergone orthotopic heart transplant for end-stage ischemic cardiomyopathy presented for a scheduled routine cardiac biopsy. The patient had no current complaints other than a crusted plaque noticed at her nasal tip. It initially manifested 6 months after surgery as a pimple that she repeatedly tried to manipulate resulting in redness and crust formation. Her immunosuppressive and prophylactic medications included: mycophenolate, tacrolimus, prednisone, bactrim, acyclovir, valganciclovir, pyrimethamine/sulfadiazine, and fluconazole. On physical examination, she was flushed, with a large and exquisitely tender crusted necrotic lesion involving almost the entire half of the nose anteriorly, the left forehead and right side of the neck. She had decreased air entry over the right lung field as well. A computed tomography (CT) image of the chest was ordered to investigate this concerning physical exam finding in the post-transplant state of this patient on immunosuppressive therapy. Chest CT revealed bilateral nodular pulmonary infiltrates with confluence in the posterior right upper lobe. Blood cultures for aerobic and anerobic organisms were negative. Both excisional biopsy of the nasal cutaneous ulcer and bronchial biopsy demonstrated numerous fungal yeast forms morphologically consistent with Blastomyces. Cultures of both specimens grew Blastomyces dermatitidis, with methicillin-resistant Staphylococcus aureus (MRSA) superinfection of the nose. She received 14 days of intravenous (IV) amphotericin B for disseminated blastomycosis and 7 days of IV vancomycin for MRSA. Her symptoms and cutaneous lesions improved and she

  17. Encefalitis: ¿cuáles y cómo tratar? Encephalitis: Which are and how to treat?

    Antonio Banfi P

    2003-01-01

    encefalitis aguda en nuestro paísViral infections, the main cause of encephalitis, invade CNS via bloodstream (e.: enterovirus, peripherical nerves (e.: rabies and less frequently, via olfactory nerve (e.: free life amoebas. Focal neuron compromise explains symptomatic variability. In Chile no one virus predominates largely and epidemiological or clinical characteristics may confuse initially. Herpes simplex encephalitis is a neurological emergency which obligates an early diagnosis to initiate specific treatment. Herpes simplex type 1 is important in children and adults and type 2 in the neonate. Isolation of herpes simplex in CSF is scarce, PCR has about 91% sensibility and high specificity continuing positive until five or seven days after sympomatology and/or treatment have started. Electroencephalogram is sensitive but unspecific. Magnetic resonance image is the most useful image diagnosis in the early acute stage of disease; CT scan allows to control the evolution. Cerebral biopsy is reserved for patients without response to treatment. Acyclovir reduces mortality and sequels of herpes simplex encephalitis while higher acyclovir dose (60 mg/kg/day has increased outcome in neonates. Valacyclovir and famcyclovir, with similar antiviral activity, could be employed to continue antiviral effect after 21 days of treatment. In enterovirus encephalitis dermatological manifestations or myocarditis may initially tend towards etiological diagnosis. Mycoplasma pneumoniae capacity to damage CNS is controversial, it can invade CSF but its pathological role subsists undefined. Less prevalent are HHV-6, Epstein-Barr virus, adenovirus, Bartonella henselae, Cryptococcus neoformans, Leptospira sp. and others. It is possible that new specific treatments may stimulate to develop technologies that allow us to explore better the etiology of acute encephalitis in our country

  18. Herpetic esophagitis: a case report on an immunocompetent adolescent Esofagitis herpética: presentación en adolescente inmunocompetente

    Susana de la Riva

    2012-04-01

    Full Text Available Herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected clinically by an acute onset of symptoms, and without apparent cause of a symptomatic triad consisting on odynophagia, heartburn and fever. Its occurrence may be due to reactivation of a previous infection or less often a primary infection. Herpes simplex type 1 is the most common cause. Upper endoscopy establishes the diagnosis of suspicion of herpetic esophagitis. It also allows to take multiple biopsy samples and viral culture, leading to a definitive diagnosis. The severity of symptoms is related to the degree of oesophageal involvement. In immunocompromised patients treatment is indicated with acyclovir, but the indication in immunocompetent patients is controversial because the process is time, limited with a low probability of complications. We present a case of acute herpetic esophagitis in an immunocompetent host that debuted acutely with severe upper gastrointestinal tract symptoms, associated with an insidious and non-specific onset of flu-like symptoms. Endoscopic findings showed a severe involvement in the lower third of the oesophageal mucosa.La esofagitis herpética en individuos inmunocompetentes, es una entidad rara, que debe de sospecharse clínicamente por el inicio agudo, y sin aparente causa, de una triada sintomática consistente en odinofagia, pirosis y fiebre. Su aparición puede deberse a una reactivación de una infección viral previa o con menor frecuencia a una primoinfección como tal, siendo el herpes tipo 1 el responsable en la mayoría de las ocasiones. La realización de una gastroscopia permite establecer el diagnóstico de sospecha de esta enfermedad y la toma de múltiples muestras para estudio histológico y cultivo viral, lo que lleva al diagnóstico definitivo. La severidad de los síntomas está en relación con el grado de afectación esofágica y aunque en los pacientes inmunocomprometidos el tratamiento con

  19. Clinical Efficacy of Oral Ganciclovir for Prophylaxis and Treatment of Recurrent Herpes Simplex Keratitis

    Wang, Xin; Wang, Linnong; Wu, Nianlang; Ma, Xinjun; Xu, Jianjiang

    2015-01-01

    Background: Herpes simplex keratitis (HSK) caused by herpes simplex virus 1 (HSV-1), which has high recurrent rate and incidence of severe vision loss, is the leading cause of infectious blindness in the world. The aim was to explore the clinical efficacy of oral ganciclovir (GCV) in the prevention of recurrent HSK. Methods: A multicenter, prospective, randomized, single-blind, and controlled clinical trial was conducted from April 2010 to June 2013. One hundred seventy-three patients (173 eyes involved) who were diagnosed as recurrent HSK definitely, including stromal keratitis and corneal endotheliitis, were divided into three groups randomly: negative control (placebo) group was topically administered with 0.15% GCV ophthalmic gel, 4 times per day and 0.1% fluorometholone eye drops, 3 times per day until resolution of HSK; positive control acyclovir (ACV) group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks. The symptoms and signs were evaluated before and after the therapy 1st week, 2nd week and then followed up every 2 weeks until recovery. Furthermore, we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time, recurrent rate and adverse reactions. Results: One hundred and seventy-three patients were followed up 7–48 months (mean 32.1 ± 12.3 months), but 34 patients were failed to follow-up. The cure time was 12.1 ± 4.3, 11.9 ± 4.0 weeks in negative control (placebo) group and positive control ACV group respectively (P = 0.991), which was longer than that in test GCV group (8.6 ± 2.8 weeks) and there was a significant difference between test GCV group and negative control (placebo) group or positive control ACV group (P = 0

  20. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review.

    2005-07-01

    receptor antagonists (e.g., oral memantine, oral dextromethorphan, intravenous ketamine, codeine, ibuprofen, lorazepam, certain 5HT1 receptor agonists, and acyclovir. Topical administration of benzydamine, diclofenac/diethyl ether, and vincristine (iontophoresis are similarly not associated with efficacy, nor are intrathecal administration of lidocaine alone or epidural administration of lidocaine and methylprednisolone, intravenous therapy with lidocaine, subcutaneous injection of Cronassial, or acupuncture. However, many of the trials that demonstrated a lack of efficacy represented comparatively low numbers of patient episodes or were single-dose studies, so it may be appropriate to regard such interventions as "not yet adequately tested" rather than demonstrating "no evidence of efficacy." Topical aspirin/diethyl ether has not been adequately tested. CONCLUSION: The evidence base supports the oral use of tricyclic antidepressants, certain opioids, and gabapentinoids in PHN. Topical therapy with lidocaine patches and capsaicin is similarly supported. Intrathecal administration of methylprednisolone appears to be associated with high efficacy, but its safety requires further evaluation.

  1. 5-(1-Substituted) alkyl pyrimidine nucleosides as antiviral (herpes) agents.

    Kumar, Rakesh

    2004-10-01

    The treatment of viral diseases remains one of the major challenges to modern medicine. During the past two decades there has been increased recognition of the consequences of serious viral illnesses that are not controlled by vaccination. These illnesses include human immunodeficiency virus, human herpes viruses, and viruses that cause hepatitis. There are now eight pathogens recognized in the herpes virus family that cause infections in humans. Infections by the herpes viruses are opportunistic and often life-threatening, leading to significant morbidity and mortality in the increasing number of chronically immune compromised individuals such as AIDS patients, cancer patients and transplant recipients on immunosuppressive therapy. Nearly all individuals with AIDS are infected with one or more of the herpes viruses. Antiviral therapy with guanosine nucleoside analogs acyclovir and ganciclovir has had a major impact on diseases caused by herpes simplex virus type-1 and type-2 (HSV-1, HSV-2), Varicella zoster virus (VZV), and human cytomegalovirus (HCMV) but development of resistant virus strains and the absence of any effective treatment for other members of the herpes family provide a stimulus for increased search of new agents effective against various herpes viruses. Pyrimidine nucleosides have taken up an important role in the therapy of virus infection. Significant progress in the study of anti-herpes nucleosides has been made by the advent of 5-substituted pyrimidine nucleosides such as 5-iodo-, 5-ethyl-, 5-(2-chloroethyl)-, and (E)-5-(2-bromovinyl)- derivatives of 2'-deoxyuridine. These are highly specific inhibitors of HSV-1, HSV-2, and/or VZV infections. However, Epstein Barr virus (EBV) and HCMV are much less sensitive to these agents. In 5-substituted pyrimidine nucleosides the nature of substituents, particularly at the C-5 position, has been found to be an important determinant of anti-herpes activity. Structural requirements at the C-2 carbon of the 5

  2. The role of medications and their management in acute kidney injury

    McDaniel BL

    2015-05-01

    injury has several drugs that are implicated as a possible cause, with antiinfectives being the most common. Postrenal injuries that result from obstruction block the flow of urine, leading to hydronephrosis and subsequent damage to the renal parenchyma. Drugs associated with tubular obstruction include acyclovir, methotrexate, and several antiretrovirals. Renal recovery from drug-induced AKI begins once the offending agent has been removed, if clinically possible, and is complete in most cases. It is uncommon that renal replacement therapy will be needed while recovery occurs. Pharmacists can play a pivotal role in identifying possible causes of drug-induced AKI and limit their toxic effect by identifying those most likely to cause or contribute to injury. Dose adjustment is critical during changes in renal function, and the pharmacist can ensure that optimal therapy is provided during this critical time. Keywords: acute kidney injury, acute renal failure, acute tubular necrosis, drug-induced kidney injury, renal insufficiency

  3. Tratamento da necrose aguda de retina: revisão sistemática Treatment of acute retinal necrosis: systematic review

    Moysés Eduardo Zajdenweber

    2005-08-01

    of acute retinal necrosis were selected. RESULTS: 146 bibliographic references were selected, 13 studies were considered relevant. Among them 2 were considered to follow the inclusion criteria. The first study tested the possibility of using intravenous acyclovir associated with corticosteroids, protecting contralateral eye from being affected. Fifty-four patients who reported unilateral acute retinal necrosis have been studied, 31 treated and 23 not treated, the disease occurring in the contralateral eye in 12.9% of the patients of the treated group and in 69.5% of the patients in the non-treated group. The second study considered treatment with photocoagulation with argon laser to prevent retinal detachment, that was observed in 57.1% of the eyes. The second included study disclosed 19 eyes affected by acute retinal necrosis, considering that 12 of these eyes were treated with photocoagulation with argon laser to prevent retinal detachment. Among the 12 eyes, 2 developed retinal detachment (16.6% while, in the non-treated group, 7 eyes, 4 developed retinal detachment (57.1%. CONCLUSION: The author concludes that both types of proposed interventions have proven to be effective. However, once the mentioned studies are methodologically considered weak, it is necessary to perform randomized clinical trials with the purpose of establishing the most suitable treatment for acute retinal necrosis.

  4. 可逆性胼胝体压部病变综合征5例%Reversible splenial lesion syndrome in 5 patients

    矫黎东; 王宪玲; 杨延辉; 王向波

    2015-01-01

    Objective To investigate the clinical features and MR features of the reversible corpus callosum lesion syndrome. Methods From January 2013 to December 2014, retrospective analysis the clinical and imaging data of 5 cases of the reversibility of the corpus callosum splenium lesion syndrome from Capital Medical University Xuanwu Hospital, Depart-ment of Neurology. Results In the 5 patients, male of 3 cases, female of 2 cases. Fever occurred in 4 cases, diarrhea in 2 cases, abnormal mental behavior in 4 cases, and epilepsy in 2 cases. All 5 cases underwent lumbar puncture expect 1 patient, CSF WBC 1 340 × 106/L, the remaining 4 cases were normal routine and biochemical CSF. 5 patients were underwent head MR 3-11 days after the onset, all were displayed as the corpus callosum pressure abnormal signal, T1WI showed low or slightly low signal, T2WI showed high or slightly high signal. DWI was high signal, and the enhanced scan revealed no en-hancement. 3 patients were treated with acyclovir treatment, 1 cases were treated with Ceftriaxone and mannitol, 1 cases trea-ted with methylprednisolone. The symptoms disappeared from 11 to 26 d after the onset of the disease, and the clinical symp-toms were completely relieved after 20 to 33 days. Conclusion Reversible corpus callosum body pressure lesion syndrome can be found in a variety of diseases, with mild clinical symptoms, radiographic changes reversible, the prognosis is good.%目的:探讨可逆性胼胝体压部病变综合征的临床特点和MR表现。方法回顾性分析2013年1月—2014年12月首都医科大学宣武医院神经内科收治的可逆性胼胝体压部病变综合征5例患者的临床及影像学资料。结果5例患者中男3例,女2例。发热4例,腹泻2例,精神行为异常4例,癫痫2例。5例均行腰穿检查,除1例患者CSF白细胞1340×106/L,其余4例CSF常规和生化均正常。5例患者分别于发病后3~11 d行头颅MR检察,均显示为胼胝体压部异常信号,T1WI

  5. Pearls and oy-sters: tuberculous meningitis: not a diagnosis of exclusion.

    Jongeling, Amy C; Pisapia, David

    2013-01-22

    A 21-year-old man presented to his local emergency department with 5 days of headache, which was dull, occipital, bilateral, nonthrobbing, and progressively worsening. It was associated with mild fever, photophobia, and neck pain and stiffness. He had no history of headache, chronic illness, recent vaccinations, cutaneous rash, cough, diarrhea, arthralgia, or myalgia. He was from Ecuador and had been living in the United States for less than 1 year. He had been incarcerated while in Ecuador. Sublingual temperature on admission was 102.6°F. Other vital signs were within normal limits. On physical examination, he appeared thin but not cachectic. He had meningismus and photophobia, but no papilledema and his mental status was alert and attentive. There were no focal neurologic deficits. CSF contained red blood cells: 24 × 10(3)/μL; white blood cells: 85/μL (lymphocytic predominant); protein: 128 mg/dL; and glucose: 48 mg/dL (CSF/serum glucose ratio = 0.53). CSF Gram stain and cultures, PPD test, and blood and urine cultures were all negative. CT scan of the head on day of admission was entirely normal. MRI without gadolinium contrast showed a single punctate T2 hyperintensity in the left frontal periventricular white matter. Chest radiograph was clear. He received empiric vancomycin, ceftriaxone, and acyclovir. Corticosteroids were not given. The patient did not improve with antibiotics and continued to be intermittently febrile. On day 5, he became abruptly more somnolent, then comatose, opening eyes only to pain, his pupils were 5 mm and reactive, he had intact brainstem reflexes, withdrawing both arms and legs. Emergent head CT showed development of hydrocephalus and a ventriculoperitoneal shunt was emergently placed. The neurologic examination did not improve after shunt placement, and repeat head CT showed increased hydrocephalus with bilateral cerebral infarcts. On day 11, he was transferred to Columbia University Medical Center for intensive care. He was

  6. Cytomegalovirus and other herpesviruses infections in heart and bone marrow transplant recipients Infecções causadas por citomegalovírus e outros vírus do grupo herpes em transplantados cardíacos e de medula óssea

    Adriana Weinberg

    1990-10-01

    Full Text Available From January 1988 to January 1989 all the heart transplant and bone marrow recipients at the Instituto do Coração of the Hospital das Clínicas of the University of São Paulo Medical School were studied for the incidence and morbidity associated with herpesviruses infections after transplantation. Five bone marrow and 5 heart transplant recipients were followed for a mean of 4.2 months post-transplantation. All the patients were seropositive for cytomegalovirus (CMV before admission and 80% experienced one or more recurrences during the observation period. Of the 12 episodes of CMV infection, that were identified in this study, 83% were accompanied by clinical or laboratory abnormalities. However, there was only one case of severe disease. The overall incidence of infection for herpes simplex (HSV was 50%. Although most of HSV reactivations were oral or genital, one case of HSV hepatitis occurred. One of the 6 episodes of HSV infections that were treated with acyclovir showed an unsatisfactory response and was successfully managed with ganciclovir. All the individuals had anti-varicella zoster virus antibodies, but none of them developed infection. The study emphasizes the importance of active diagnostic surveillance of herpesvirus infections in transplant patients. Both CMV and HSV reactivations showed high incidence and important morbidity and thus, deserve prophylactic therapy.De janeiro de 1988 a janeiro de 1989 todos os pacientes submetidos a transplante de coração ou de medula óssea no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram estudados quanto à incidência e morbidade das infecções pós-transplante causadas por vírus do grupo herpes. Cinco recipientes de medula óssea e 5 transplantados cardíacos foram observados por um período médio de 4.2 meses após o transplante. Todos os pacientes tinham sorologia positiva para citomegalovírus (CMV antes do transplante

  7. Clinical Efficacy of Oral Ganciclovir for Prophylaxis and Treatment of Recurrent Herpes Simplex Keratitis

    Xin Wang

    2015-01-01

    Full Text Available Background: Herpes simplex keratitis (HSK caused by herpes simplex virus 1 (HSV-1, which has high recurrent rate and incidence of severe vision loss, is the leading cause of infectious blindness in the world. The aim was to explore the clinical efficacy of oral ganciclovir (GCV in the prevention of recurrent HSK. Methods: A multicenter, prospective, randomized, single-blind, and controlled clinical trial was conducted from April 2010 to June 2013. One hundred seventy-three patients (173 eyes involved who were diagnosed as recurrent HSK definitely, including stromal keratitis and corneal endotheliitis, were divided into three groups randomly: negative control (placebo group was topically administered with 0.15% GCV ophthalmic gel, 4 times per day and 0.1% fluorometholone eye drops, 3 times per day until resolution of HSK; positive control acyclovir (ACV group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks. The symptoms and signs were evaluated before and after the therapy 1 st week, 2 nd week and then followed up every 2 weeks until recovery. Furthermore, we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time, recurrent rate and adverse reactions. Results: One hundred and seventy-three patients were followed up 7-48 months (mean 32.1 ± 12.3 months, but 34 patients were failed to follow-up. The cure time was 12.1 ± 4.3, 11.9 ± 4.0 weeks in negative control (placebo group and positive control ACV group respectively (P = 0.991, which was longer than that in test GCV group (8.6 ± 2.8 weeks and there was a significant difference between test GCV group and negative control (placebo group or positive control ACV group (P

  8. 妊娠期水痘感染对母婴的影响(附13例临床分析)

    岳欣; 成骢; 韩国荣; 明亚玲; 阚乃颖; 徐征洪

    2015-01-01

    目的:探讨妊娠合并水痘对母婴结局的影响和治疗方法。方法对2012年1月至2014年6月南京市第二医院妊娠合并水痘患者资料进行回顾性分析。结果13例妊娠合并水痘发病孕周分别为14周1例,20~28周2例,32周1例,37~40周9例。其中孕妇发热11例,继发性皮肤感染3例,未出现水痘肺炎、脑炎。所有孕妇均足月分娩,胎儿宫内窘迫1例,剖宫产7例,产后出血4例,无先天性水痘综合征患儿,新生儿水痘2例。结论孕妇感染水痘应经妇产科、感染科医生共同诊断治疗,围生期特别是水痘完全结痂期前分娩的新生儿可能患水痘,静脉给予丙种球蛋白可预防新生儿水痘的发生。%Objective To study the effects of pregnancy complicated with varicella to maternal and neo‐natal outcomes and treatment methods .Method 13 cases of pregnancy complicated with varicella in the department of the Second Affiliated Hospital between January 2012 and June 2014 were selected in the study .Results Varicella infection time:14 weeks of pregnancy 1 cases ,2 cases with 20~28 weeks ,1 ca‐ses with 32 weeks ,37~40 weeks in 9 cases;11 cases of pregnant women with fever in 13 cases ,3 cases of secondary infection of the skin ,do not appear varicella pneumonia ,encephalitis ;pregnancy outcome:all full‐term delivery ,fetal distress in 1 cases ,cesarean section in 7 cases ,4 cases of postpartum hemorrhage in children with congenital varicella syndrome ,no congenital varicella syndrome ,2 cases of neonatal vari‐cella .Conclusions Infection of pregnant women with varicella patients should be diagnosed and treated by department of gynecology and obstetrics ,department of infection during pregnancy ,reasonable application of acyclovir antiviral treatment ,strengthen the maternal fetal monitoring during the pregnancy ,perinatal especially varicella completely crusted period before delivery of the neonate may be suffering from

  9. Valganciclovir for cytomegalovirus prevention in solid organ transplant patients: an evidence-based reassessment of safety and efficacy.

    Andre C Kalil

    .14] (p = 0.04. All results remained consistent across different study designs, valganciclovir doses, and CMV serostatus. CONCLUSIONS: Valganciclovir shows no superior efficacy and significantly higher risk of absolute neutropenia, CMV late-onset disease, and CMV tissue-invasive disease compared to other standard therapies. Due to the availability of efficacious, safer, and lower cost drugs (high-dose acyclovir, valacyclovir, ganciclovir, our results do not favor the use of valganciclovir as a first-line agent for CMV preemptive or universal prophylaxis in SOT patients.

  10. 单纯疱疹病毒性脑炎60例临床分析%Clinical analysis of 60 cases with herpes simplex virus encephalitis

    王学义; 邹卿; 蒲涛

    2012-01-01

    , accompanied by lips or genital skin or mucosal herpes. The patients firstly appears headache, nausea, vomiting, fever, some with psychiatric symptoms (auditory hallucinations, visual hallucinations, speech disorders, personality changes, dysphoria or lack of facial expression) , repeated partial seizures and epilepsy stale, central facial paralysis, paralysis of limbs, disturbance of consciousness ( delirium, lethargy, drowsiness, shallow, middle, deep coma). The state of illness reached a peak from a few hours to several days. The detection of virus-specific antibody of cerebrospinal fluid: HSV-specific IgM was positive with 54 cases in a week, remained six cases were positive in 2 weeks. There were 20 cases whose HSV specific antibody IgG and IgE of paired cerebrospinal fluid in convalescence was more than 4 times. Other check of cerebrospinal fluid; most of cerebrospinal fluid was abnormal,such as increased pressure ( >200mmH2O) , leukocytosis. Some showed increase in red blood cells and light-moderate increase in protein, sugar and chloride were normal, without bacterial growth by smearing and culturing, and without cancer cells and malignant cells by pathological examination. Head CT and MRI: 60 patients with head CT scan in the onset of two weeks, most of the CT examination revealed abnormal. The most of patients with normal head CT had anomalistic head MRI. EEG: Most of them is abnormal. Diffuse abnormalities was in the majority, including severe abnormal in 18 cases, moderately abnormal in 20 cases, mildly abnormal in 20 cases. Prognosis: most of them is good, except six cases with death. Conclusion Herpes simplex virus encephalitis by clinical diagnostic criteria easily is diagnosed, the state of an illness is usually critical by anti-virus with using acyclovir and symptomatic treatment, the prognosis is good in the majority of the HSE patients, donot left over after-effects, but some have very poor prognosis, with different degrees of sequela and even death.

  11. 异基因造血干细胞移植治疗母细胞性浆细胞样树突细胞肿瘤%Allogeneic hematopoietic stem cell transplantation for blastic plasmacytoid dendritic cell neoplasms

    周红升; 许娜; 孙竞; 邓永键; 江千里; 余国攀; 刘启发

    2012-01-01

    Objective To investigate the effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with intensified conditioning regimen followed by rapidly tapering immunosuppressants and sequential minimal residual disease (MRD)-guided donor lymphocyte infusion (DLI) post-transplantation on outcome of blastic plasmacytoid dendritic cell neoplasm (BPDCN).Methods Two cases of BPDCN from January 2009 to May 2011 in Nanfang hospital were diagnosed according to 2008 WHO classification of tumours of haematopoietic and lymphoid tissues.Case 1 initially presented with typical cutaneous involvement and was promptly diagnosed with CD+4CD+56LCA+TdT+CD+43 BPDCN by skin biopsy.Case 2 was recognized as acute lymphocyte leukemia and acute non-lymphocytic leukemia,which was diagnosed to BPDCN at recurrence through flow cytometry analysis.Total-body-irradiation plus cyclophosphamide based intensified conditioning regimen were followed by allo-HSCT from sibling donor.Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate.Anti-thymocyteglobulin was included additionally for haploid donor allo-HSCT.Multi-color labeling flow cytometry was performed to monitor MRD.Rapidly tapering of prophylactic immunosuppressants and sequential MRD-guided donor lymphocyte infusion (DLI) were performed to control relapse of primary malignancy.Results Two cases of BPDCN received allo-HSCT from sibling donor after intensified conditioning regimen.Both patients achieved complete remission and complete donor engraftment.Case 1 survived refractory acyclovir-resistant Epstein-Barr virus viremia benefiting from preemptive treatment with rituximab and DLI-induced grade Ⅳ acute GVHD,but died of thrombotic microangiopathy mixed with diffuse alveolar hemorrhage and sepsis on +243 days.Case 2 relapsed just 2 months after allo-HSCT despite DLI and rapidly tapering of CsA,died of sepsis followed by diffuse intravascular coagulation on +101 days.Conclusion BPDCN is