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[Acyclovir-resistant herpes exulcerans et persistens. Type II]
Summary
Acyclovir-resistant herpes simplex virus infections are increasing in immunocompromised patients. Intravenous foscarnet effectively treated a patient with B-cell leukemia, leading to near-complete remission of perianal ulcerations.
Area of Science:
- Infectious Diseases
- Hematology
- Pharmacology
Background:
- Rising incidence of acyclovir-resistant herpes simplex virus (HSV) infections in immunocompromised individuals.
- Need for evaluating alternative antiviral treatments considering patient-specific risks and side effects.
Observation:
- A 73-year-old female patient with B-cell lymphatic leukemia, secondary antibody deficiency, and anemia presented with a year-long history of perianal ulcerations.
- The ulcerations were caused by a persistent acyclovir-resistant herpes simplex virus type II infection.
Findings:
- Intravenous foscarnet was administered, drawing on prior successful treatments for acyclovir-resistant HSV with foscarnet, cidofovir, or vidarabine.
- After three months of foscarnet treatment, the patient's perianal ulcerations demonstrated nearly complete remission.
Implications:
- Foscarnet represents a viable therapeutic option for managing acyclovir-resistant HSV infections in immunocompromised patients with complex comorbidities.
- Successful treatment highlights the importance of individualized therapeutic strategies in managing refractory viral infections.