Acyclovir-Induced Nephrotoxicity: A Case Report

Acyclovir is a widely used antiviral medication known for its potential nephrotoxic effects. These adverse effects may include acute kidney injury (AKI), acute tubulointerstitial nephritis, crystal-induced nephropathy, and, in rare cases, tubular dysfunction. While acyclovir is generally considered safe, nephrotoxicity can occur, particularly when administered at high doses or in dehydrated patients. We present the case of a 20-year-old woman who was previously in good health but developed acute kidney failure 48 hours after initiating intravenous acyclovir at a standard meningeal dose of 15 mg/kg every eight hours for suspected herpetic meningoencephalitis. Upon suspicion of drug-induced nephrotoxicity, acyclovir was discontinued, leading to a rapid improvement in renal function within 24 hours. This case highlights the importance of close monitoring in patients receiving acyclovir, particularly those at an increased risk of nephrotoxicity. To ensure early detection and intervention, it is crucial to perform regular renal function assessments, especially within the first 48 hours of treatment.