acyclovir and Chickenpox

acyclovir has been researched along with Chickenpox* in 586 studies

Reviews

135 review(s) available for acyclovir and Chickenpox

ArticleYear
Herpes Simplex Virus and Varicella Zoster Virus Infections in Cancer Patients.
    Viruses, 2023, 02-05, Volume: 15, Issue:2

    Herpes simplex virus (HSV) and varicella zoster virus (VZV) are alpha herpesviruses that establish life-long latent infection in neuronal ganglia after primary infection. Periodic reactivation of these viruses results in recurrent infections that can have significant impact on patients' quality of life. HSV commonly causes oral and genital mucocutaneous infections whereas VZV is responsible for varicella/chickenpox and herpes zoster/shingles, but cancer patients are at particularly higher risk of complications including disseminated and visceral infections due to impaired cell-mediated immunity. While diagnosis of more common HSV and/or VZV infections is frequently clinically based, immunocompromised hosts may have atypical skin presentation or visceral involvement. Thus, diagnostic confirmation using virus-specific tests such as polymerase chain reaction or immunohistochemical staining is crucial in some cases. Oral acyclovir, valacyclovir and famciclovir are usually used for mild to moderate infections and intravenous acyclovir is the drug of choice for severe or disseminated infections. Foscarnet can be used when acyclovir-resistance is confirmed or suspected. Pharmaceutical prophylaxis against HSV and/or VZV should be considered in high-risk cancers patients. Currently, there is no commercially available vaccine against HSV, but VZV vaccines are available to prevent varicella and zoster.

    Topics: Acyclovir; Chickenpox; Herpes Zoster; Herpesvirus 3, Human; Humans; Neoplasms; Quality of Life; Simplexvirus; Varicella Zoster Virus Infection

2023
Retinal vasculopathy following varicella zoster virus infection.
    Current opinion in ophthalmology, 2022, Nov-01, Volume: 33, Issue:6

    Varicella zoster virus (VZV) ocular infection can manifest purely as a vasculopathy that leads to retinal arteriole occlusion, without any retinitis or vasculitis. This review summarizes our current knowledge of such VZV ocular infection phenotype, incorporating initial descriptions from 1988. We describe the pathogenesis and VZV's manifestations in the retina using fundus photography, fundus fluorescein angiography, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Laboratory investigations, diagnostic procedures, prognoses, and treatment options are also being reviewed.. Ten case reports where VZV retinal vasculopathy was the primary feature observed after varicella or zoster rash are described. The retinal arteriole, cilioretinal artery, branches of retinal artery, central retinal artery and ophthalmic artery were found to be areas of more rarely affected, neither in the form of vasculitis nor retinitis. Diagnosis is typically made from positive polymerase chain reaction (PCR) for VZV from extracted intraocular fluid or positive serum or cerebrospinal fluid (CSF) anti-VZV immunoglobulin G antibody in the context of compatible ocular findings. In addition, retinal vasculopathy occurring in the setting of confirmed varicella or zoster rashes could be considered potentially pathognomonic. Pathological concepts, including direct VZV infection of affected tissue, persistent inflammation, and/or virus-induced hypercoagulability are also discussed.. VZV may produce a wide spectrum of ocular manifestations with isolated VZV retinal vasculopathy being a rarer presentation. A prompt diagnosis followed by an early treatment of systemic acyclovir with or without corticosteroids is the mainstay of treatment.

    Topics: Acyclovir; Chickenpox; Eye Infections; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunoglobulin G; Retinitis; Vasculitis

2022
Bilateral vocal cord paralysis in Miller Fisher syndrome/Guillain-Barre overlap syndrome and a review of previous case series.
    BMJ case reports, 2021, Jan-27, Volume: 14, Issue:1

    Miller Fisher syndrome (MFS), an acute demyelinating neuropathy, is characterised by a triad of areflexia, ataxia and ophthalmoplegia. It is the most common variant of Guillain-Barre Syndrome (GBS). In about 5.6%-7.1% of MFS cases, patients also suffer from progressive motor weakness of the limbs. This condition is termed MFS/GBS overlap syndrome. Whether it is in MFS or GBS, bilateral vocal cord paralysis (BVCP) is a rare manifestation with limited cases reported in the literature. We report an extremely rare case where a 65-year-old man developed BVCP in an MFS/GBS overlap syndrome. We have also reviewed previous case reports in the literature for comparison.

    Topics: Acyclovir; Aged; Antiviral Agents; Chickenpox; Disease Progression; Electrodiagnosis; Guillain-Barre Syndrome; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Male; Miller Fisher Syndrome; Neural Conduction; Tracheostomy; Vocal Cord Paralysis

2021
Acyclovir-induced neurotoxicity with a positive cerebrospinal fluid varicella zoster PCR result creating a management dilemma: a case report.
    Journal of medical case reports, 2020, Sep-18, Volume: 14, Issue:1

    Varicella zoster virus central nervous system infections can present as aseptic meningitis, encephalitis, myelitis, and vasculopathy. Diagnosis is based on identification of varicella zoster virus deoxyribonucleic acid (DNA) in the cerebrospinal fluid by polymerase chain reaction. Therapy for these infections is acyclovir or valacyclovir. However, acyclovir can have neurotoxic effects that can mimic the presentation of varicella zoster virus central nervous system disease. We present a rare presentation of a patient who had acyclovir-induced neurotoxicity who also had a false-positive cerebrospinal fluid varicella zoster virus polymerase chain reaction result, creating a management dilemma. We review the clinical characteristics of acyclovir-induced neurotoxicity. In addition, we present the diagnostic characteristics of the cerebrospinal fluid viral polymerase chain reaction and alternative methods to diagnose central nervous system varicella zoster virus disease.. A 68-year-old Hispanic man with end-stage renal disease was diagnosed with cutaneous zoster at an outside facility and was started on acyclovir 4 days prior to admission. His family noted worsening confusion, agitation, speech difficulty, and hallucinations, leading them to bring him to the emergency department. His cerebrospinal fluid varicella zoster virus polymerase chain reaction result was positive, indicating the presence of varicella zoster virus deoxyribonucleic acid in the cerebrospinal fluid; however, he did not have cerebrospinal fluid pleocytosis typical of varicella zoster virus meningoencephalitis. Pharmacy records from the outside hospital revealed supratherapeutic acyclovir dosing. This led to a diagnostic dilemma over whether this patient had varicella zoster virus encephalitis or acyclovir-induced neurotoxicity. Acyclovir was discontinued, and the patient underwent two sessions of hemodialysis to remove acyclovir, which led to a full neurologic recovery.. Varicella zoster virus encephalitis and acyclovir-induced neurotoxicity can have similar presentations. Varicella zoster virus deoxyribonucleic acid can be present in the cerebrospinal fluid during active cutaneous zoster in the absence of central nervous system disease. If concern for central nervous system varicella zoster virus disease remains high, additional testing with cerebrospinal fluid serology can be performed. Compared with central nervous system varicella zoster virus disease, acyclovir-induced neurotoxicity has a more predictable clinical resolution once drug therapy is discontinued or the patient undergoes hemodialysis, which can aid in making the diagnosis. Clinicians should be aware of this rare and dangerous complication of acyclovir. In addition, clinicians should have an understanding of the diagnostic limitations of cerebrospinal fluid viral polymerase chain reaction and have alternative approaches available to diagnose central nervous system varicella zoster virus disease when it is suspected.

    Topics: Acyclovir; Aged; Antiviral Agents; Chickenpox; Herpes Zoster; Humans; Male; Polymerase Chain Reaction

2020
Fifteen-minute consultation: Prevention and treatment of chickenpox in newborns.
    Archives of disease in childhood. Education and practice edition, 2020, Volume: 105, Issue:1

    There are inconsistencies in how newborns are managed following exposure to varicella, ranging from reassurance and observation to administration of varicella zoster immunoglobulin (VZIG) and admission to hospital for varying length courses of intravenous aciclovir.Hospitalised preterm babies exposed to varicella should receive VZIG. Administration can otherwise be limited to pregnant non-immune women or to newborns if there is development of maternal chickenpox from 5 days prior to delivery up to 48 hours postdelivery. Intravenous aciclovir is only recommended in cases of newborn disease despite VZIG or in severe disease. The use of VZIG may not prevent varicella but may reduce severity of disease.In this article, we review the evidence for risk to non-immune mothers, the fetus and newborns who had different types of exposure to varicella, with recommendations for management and treatment of confirmed neonatal chickenpox.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Immune Sera; Infant, Newborn; Infant, Premature; Pregnancy; Pregnancy Complications, Infectious

2020
Is acyclovir effective for the treatment of varicella in children and adolescents?
    Medwave, 2018, Oct-04, Volume: 18, Issue:6

    Varicella (chickenpox) is a frequent and highly contagious infectious disease, caused by the Varicella zoster virus. Traditionally, it has been recommended to focus on the management of symptoms, since there is controversy about the role of antivirals, particularly in children and adolescents.. To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.. We identified three systematic reviews including three studies overall, all of them corresponding to randomized trials. We concluded the use of acyclovir might not decrease the associated complications, and it is not clear whether it reduces lesions or itching because the certainty of the evidence is very low.. La varicela es una enfermedad infecciosa frecuente y altamente contagiosa, producida por el virus Varicella Zoster. Tradicionalmente se ha recomendado tratarla en forma sintomática, ya que existe controversia en relación a la utilidad del tratamiento antiviral, en especial en niños y adolescentes.. Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE.. Identificamos tres revisiones sistemáticas, que en conjunto incluyen tres estudios primarios, todos correspondientes a ensayos aleatorizados. Concluimos que el uso de aciclovir podría no disminuir las complicaciones asociadas, y no está claro si disminuye las lesiones o el prurito porque la certeza de la evidencia es muy baja.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Databases, Factual; Humans; Pruritus; Randomized Controlled Trials as Topic; Treatment Outcome

2018
Varicella in a Previously Immune Patient With Leukemia.
    Journal of the Pediatric Infectious Diseases Society, 2017, Jun-01, Volume: 6, Issue:2

    Infection with varicella-zoster virus (VZV) in oncology patients can result in severe disease with an increased risk of morbidity and mortality [1, 2]. Among patients on cancer chemotherapy, only nonimmune persons are considered to be susceptible to varicella [1]. We present a case of varicella in a child with leukemia that occurred despite immunity as defined by 2 doses of varicella vaccine and documentation of positive VZV immunoglobulin G titer before initiation of chemotherapy.

    Topics: Acyclovir; Antibodies, Viral; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Herpesvirus 3, Human; Humans; Male; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma

2017
Nursing management of childhood chickenpox infection.
    Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association, 2017, Dec-08, Volume: 25, Issue:8

    Chickenpox is an extremely contagious infectious disease caused by varicella zoster virus (VZV). It is a common childhood illness characterised by an itchy vesicular rash and fever, which usually resolves spontaneously without medical intervention. Serious, and rarely fatal, complications can occur, including pneumonia, central nervous system infection, overwhelming secondary bacterial infections, especially with Group A streptococcus, and necrotising fasciitis. Therefore it is crucial that emergency department (ED) nurses can recognise the signs and symptoms that indicate deterioration. This article reviews best practice management of children with chickenpox, gives up-to-date guidance on the safe use of antipyretics, the avoidance of ibuprofen and discusses immunisation against VZV. It also includes implications for nursing practice and a case study that illustrates some of the challenges that ED nurses may encounter.

    Topics: Absenteeism; Acyclovir; Antipyretics; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Cost of Illness; Diagnosis, Differential; Emergency Nursing; Herpesvirus 3, Human; Humans; Nursing Assessment; Physical Examination; Quality-Adjusted Life Years; Recurrence

2017
Chickenpox: treatment.
    BMJ clinical evidence, 2015, Jun-15, Volume: 2015

    Chickenpox is extremely contagious. More than 90% of unvaccinated people will become infected during their lifetime, but infection occurs at different ages in different parts of the world. In the US, the UK, and Japan, more than 80% of people have been infected by the age of 10 years, and by the age of 20 to 30 years in India, South East Asia, and the West Indies. It is usually a mild and self-limiting disease, but it can be severely complicated by pneumonitis or disseminated disease in some individuals, particularly neonates and those who are immunocompromised.. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatment for chickenpox in healthy adults and children (including neonates) within 24 hours after onset of rash? What are the effects of treatment for chickenpox in healthy adults and children (including neonates) later than 24 hours after onset of rash? What are the effects of treatment for chickenpox in immunocompromised adults and children (including neonates)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).. We found six studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.. In this systematic overview we present information relating to the effectiveness and safety of aciclovir, within 24 hours of onset of rash or later than 24 hours of onset of rash, in otherwise-healthy adults and children (including neonates); and aciclovir in immunocompromised adults and children (including neonates).

    Topics: Acyclovir; Chickenpox; Humans; Immunocompromised Host; India; Treatment Outcome

2015
Successful rescue of disseminated varicella infection with multiple organ failure in a pediatric living donor liver transplant recipient: a case report and literature review.
    Virology journal, 2015, Jun-17, Volume: 12

    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.

    Topics: Acyclovir; Antibodies, Viral; Chickenpox; Child; DNA, Viral; Exanthema; Female; Herpesvirus 3, Human; Humans; Immunocompromised Host; Immunoglobulin G; Immunoglobulins, Intravenous; Liver Transplantation; Living Donors; Multiple Organ Failure; Transplant Recipients; Treatment Outcome; Viral Load

2015
[Adults with chickenpox in the tropics].
    Nederlands tijdschrift voor geneeskunde, 2015, Volume: 160

    In our hospital in the Dutch Caribbean, it is not uncommon for adults to be admitted for chickenpox infection. In contrast to the situation in temperate climates, not all adults are infected during childhood. Therefore, hospital staff are tested when first employed; of those aged between 20-29 years, 40% do not have antibodies against the varicella-zoster virus (VZV). We describe three cases of adults, aged 37, 51 and 90 years respectively, who presented with chickenpox. Compared to children, the clinical course in adults is more severe with the potential risk of life-threatening complications. In pregnancy or concomitant T cell immune deficiency, risk of a fulminant course is even higher. Treatment with aciclovir or valaciclovir is effective and associated with few side-effects. Passive immunization with VZV-immunoglobulin is indicated within 96 hours of exposure, typically followed by acyclovir or valaciclovir. As migration occurs from low endemic tropical areas to high endemic temperate areas, we should be aware of the risk of adult chickenpox in these migrants.

    Topics: Acyclovir; Adult; Aged, 80 and over; Antibodies; Caribbean Region; Chickenpox; Female; Herpesvirus 3, Human; Hospitals; Humans; Immunization, Passive; Male; Middle Aged; Personnel, Hospital; Pregnancy; Valacyclovir; Valine

2015
[Varicella-zoster virus and pregnancy].
    Presse medicale (Paris, France : 1983), 2014, Volume: 43, Issue:6 Pt 1

    The incidence of varicella is low in pregnant women, and estimated around 1/1000 pregnancies. Vaccination is the cornerstone of prevention, but is contraindicated during pregnancy. Varicella is more severe in pregnant women. The risk of viral pneumonia is not increased, but VZV-associated pneumonia is usually more severe in pregnant women. Infection between 0-20 WG is associated with a 2 % risk of congenital varicella syndrome. Infection between D-5 and D+2 of delivery is associated with high risk of severe neonatal infection. Non-immune pregnant women with significant exposure to VZV require post-exposure prophylaxis with specific anti-VZV immunoglobulins that should be administered ideally within 4 days post-exposure and maximum within 10 days of exposure. Anti-VZV immunoglobulins are available in France in the context of an approved expanded access to an investigational new drug. Pregnant women with varicella should receive within 24 hours antiviral treatment based either on valaciclovir or, in case of severe infection, intravenous aciclovir. Both drugs were shown safe during pregnancy, even during the first trimester. Neonates born from mothers who developed varicella between D-5 and D+2 of delivery should also receive as soon as possible specific anti-VZV immunoglobulins.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Chickenpox Vaccine; Contraindications; Female; Humans; Immunization, Passive; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious; Valacyclovir; Valine

2014
The use of antiviral drugs during the neonatal period.
    Clinics in perinatology, 2012, Volume: 39, Issue:1

    Parenteral therapy of viral infections of the newborn and infant began with vidarabine (adenine arabinoside) for the treatment of neonatal herpes simplex virus (HSV) infections in the early 1980s. Acyclovir has become the treatment of choice for neonatal HSV infections and a variety of other herpesvirus infections. Ganciclovir is beneficial for the treatment of congenital cytomegalovirus (CMV) infections involving the central nervous system (CNS). This article reviews the use of acyclovir and ganciclovir in the treatment of neonatal HSV and congenital CMV infections. A brief summary precedes a detailed discussion of available established and alternative therapeutics.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Cytomegalovirus Infections; Drug Interactions; Female; Ganciclovir; Herpes Simplex; Humans; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy

2012
Varicella-zoster virus: Prevention through vaccination.
    Clinical obstetrics and gynecology, 2012, Volume: 55, Issue:2

    Widespread use of varicella vaccine in the United States has drastically changed the epidemiology of the disease. Although chickenpox is no longer a ubiquitous childhood infection, varicella-zoster virus continues to circulate in the community and nonimmune pregnant women remain at risk. Varicella can cause severe infection in pregnant women, often complicated by viral pneumonia. Maternal varicella occurring in the first half of pregnancy can cause the rare but devastating congenital varicella syndrome, whereas infection in the late stages of pregnancy may cause neonatal varicella. The best approach to avoiding the morbidity and mortality associated with chickenpox in pregnancy is to screen and vaccinate susceptible reproductive-age women.

    Topics: Acyclovir; Antiviral Agents; Chemoprevention; Chickenpox; Chickenpox Vaccine; Disease Susceptibility; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunization, Passive; Immunoglobulins; Immunologic Factors; Infant, Newborn; Pneumonia, Viral; Postnatal Care; Preconception Care; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care

2012
Preventing varicella in children with malignancies: what is the evidence?
    Current opinion in infectious diseases, 2011, Volume: 24, Issue:3

    The prevention of varicella in children with cancer is generally agreed to be an important goal, because of their elevated risk of varicella zoster virus (VZV)-associated morbidity and mortality. However, there is a lack of consensus on the best means of achieving this. Here, we review the existing evidence in relation to postexposure prophylaxis against varicella in this group and summarize data regarding the role of active vaccination.. Death from varicella during treatment for cancer is now rare, but VZV disease and its prevention remain significant problems in paediatric oncology practice. Measures to reduce VZV exposure amongst seronegative individuals are often neglected. When exposure is known to have occurred, early administration of varicella zoster immune globulin (VZIG) is generally protective against severe and complicated varicella. However, many centres in the UK and Japan use an oral antiviral agent, aciclovir, in place of VZIG. Published evidence for the efficacy of aciclovir as postexposure prophylaxis (PEP) relates mostly to healthy children, with no controlled studies in the immunocompromised.. Good evidence already supports the administration of varicella vaccine to healthy susceptible family contacts of children with malignancy, but not to patients themselves. Further data are urgently needed to inform the choice of PEP against VZV in the immunocompromised.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Humans; Immune Sera; Japan; Neoplasms; Post-Exposure Prophylaxis; United Kingdom

2011
[Post-exposure varicella prophylaxis].
    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2011, Sep-06, Volume: 131, Issue:17

    Varicella may have a serious and sometimes fatal course, especially in immunocompromised patients. Some patient groups may need prophylaxis after exposure to the varicella-zoster-virus. In this article we review the evidence for usefulness of prophylactic measures after such exposure.. The article is based on a non-systematic literature search in Medline, the Cochrane Library, UpToDate and Clinical Evidence.. The effect of post-exposure varicella prophylaxis on disease rate and severity of varicella is only weakly documented. There is some evidence that passive immunisation with varicella-zoster immunoglobulin (VZIG) reduces the risk of serious disease when it is administered within 72-96 hours after exposure. Several studies of mostly healthy children have shown that prophylactic acyclovir is better than control treatment, but the studies are small and they are not properly designed. Post-exposure vaccination is shown to reduce disease rate and severity in otherwise healthy children.. We believe that acyclovir or valacyclovir can be used as post-exposure varicella prophylaxis in risk patients for whom the time window for VZIG-use has expired.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Humans; Immune Sera; Immunocompromised Host; Infant, Newborn; Infant, Premature; Risk Factors; Time Factors; Valacyclovir; Valine

2011
Varicella infection and the impact of late entry into the Irish healthcare system.
    Journal of infection and public health, 2010, Volume: 3, Issue:3

    We present a case which highlights several areas of concern relating to the prevention and management of varicella in Ireland. We review the pathophysiology of this virus and highlight its greater potential for morbidity in certain groups, most particularly adult males. The experience and opinions with regard to varicella vaccination in the US and other temperate countries is reviewed along with evidence of changing epidemiology of varicella infection. The National Immunisation Advisory Committee (NIAC) guidelines are reviewed in the context of our experience.

    Topics: Acetaminophen; Acyclovir; Adult; Antipyretics; Antiviral Agents; Brugada Syndrome; Chickenpox; Chickenpox Vaccine; Emigrants and Immigrants; Herpesvirus 3, Human; Humans; Ireland; Male; Sri Lanka; Tachycardia, Ventricular; Vaccination

2010
[Ocular complications in eruptive diseases of childhood].
    Oftalmologia (Bucharest, Romania : 1990), 2009, Volume: 53, Issue:1

    Childhood infectious diseases are not usually serious. The symptoms (fever, conjunctivitis, itching) diminish with the administration of antipyretic drugs. Cutaneous lesions leave no scarring. Sometimes complications may appear.

    Topics: Acyclovir; Administration, Cutaneous; Antiviral Agents; Chickenpox; Child; Chorioretinitis; Conjunctivitis, Viral; Drug Therapy, Combination; Eye Infections, Viral; Glucocorticoids; Humans; Measles; Mumps; Pruritus; Rubella; Skin Diseases, Viral; Treatment Outcome

2009
[Herpesvirus infections of the immunocompetant child and adult].
    La Revue du praticien, 2009, Nov-20, Volume: 59, Issue:9

    Topics: Acetaminophen; Acyclovir; Administration, Oral; Adult; Aged; Analgesics, Non-Narcotic; Antiviral Agents; Chickenpox; Child, Preschool; Female; Herpes Simplex; Herpes Zoster; Herpes Zoster Ophthalmicus; Humans; Immunocompetence; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious; Prognosis; Recurrence; Seroepidemiologic Studies; Valacyclovir; Valine

2009
Clinicopathologic understanding and control of varicella-zoster virus infection.
    Vaccine, 2008, Nov-25, Volume: 26, Issue:50

    As reflections by the recipient for the Japanese society for vaccinology Takahashi award, clinicopathologic understanding and control of varicella-zoster virus (VZV) infection was briefly reviewed. In 1974, a live varicella vaccine was developed by attenuating the Oka strain of VZV after the passages in non-human cells at a low temperature. The vaccine was immunogenic, well tolerated, and effective, and distributed worldwide so far. For post-exposure prophylaxis of varicella, the vaccine and acyclovir is effectively used in the incubation period of varicella. The delayed type hypersensitivity to VZV skin test antigen was applied for evaluation of cell-mediated immunity to VZV which is commercially available in Japan. The biphasic viremia during incubation period of varicella and airborne spread of VZV from varicella patients and from herpes zoster patients with localized lesions were shown by the virus isolation or by detection of the virus DNA.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Herpes Zoster; Herpesvirus 3, Human; Humans; Skin Tests

2008
[Varicella pneumonia].
    Praxis, 2008, Sep-24, Volume: 97, Issue:19

    The seroprevalence of chickenpox in countries with temperate climate is very high among young people. Only 4% of the infections occur in adults but the clinical course is usually more severe than in children. In adults, The mortality is approximately 40 times higher and the complication rate 25 times higher than in children. Pneumonia is the most frequent complication in adults and may be extremely severe in immunocompromised patients and in pregnant women. Pneumonia must be promptly treated with intravenous aciclovir. Vaccination is indicated in young seronegative patients with supplemental risk factors for severe complications. It is also effective post exposure, preventing or modifying the illness course in up to 90% of exposed people if given within 3 days. Immunoglobulins may be effective as late as 96 hours after exposure. They are frequently used for exposed people at high risk of severe disease, when varicella vaccine is contraindicated.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Female; Humans; Pneumonia, Viral; Valacyclovir; Valine

2008
Foscarnet salvage therapy for acyclovir-resistant varicella zoster: report of a novel thymidine kinase mutation and review of the literature.
    The Pediatric infectious disease journal, 2008, Volume: 27, Issue:1

    The authors describe an acyclovir-resistant varicella zoster virus infection in a pediatric patient after hematopoietic stem cell transplant, the use of foscarnet as salvage therapy, and review the literature to clarify the pediatric experience with foscarnet in this setting. A novel thymidine kinase mutation is described, along with a new phenotypic assay for characterizing acyclovir resistance in varicella zoster virus.

    Topics: Acyclovir; Chickenpox; Child; Drug Resistance, Viral; Female; Foscarnet; Herpesvirus 3, Human; Humans; Microbial Sensitivity Tests; Mutation; Salvage Therapy; Thymidine Kinase

2008
Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 2: Varicella-zoster virus infections.
    Medical microbiology and immunology, 2007, Volume: 196, Issue:2

    Varicella during pregnancy can be associated with severe illnesses for both the mother and her neonate. Varicella pneumonia must be regarded as a medical emergency, since pregnant women are at risk of life-threatening ventilatory compromise and death. After maternal chickenpox in the first and second trimesters, congenital varicella syndrome may occur in nearly 2% of the cases. The characteristic symptoms consist of skin lesions in dermatomal distribution, neurological defects, eye diseases and skeletal anomalies. If the mother develops varicella rashes between day 4 (5) antepartum and day 2 postpartum, generalized neonatal varicella leading to death in about 20% of the cases has to be expected. Normal zoster has not been shown to be associated with maternal pneumonia, birth defects or problems in the perinatal period. On the basis of the clinical consequences of varicella-zoster virus infections during pregnancy, the present paper summarizes the currently available concepts of prevention, diagnosis and therapy.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Herpesvirus 3, Human; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious

2007
Acute retinal necrosis complicating chickenpox in a healthy adult--a case report and review of literature.
    Comprehensive therapy, 2007,Spring, Volume: 33, Issue:1

    Acute retinal necrosis (ARN) is known to occur in conjunction with primary varicella or chickenpox infection. The majority of ARN cases reported in the literature were of milder form with mild to moderate vitritis, limited retinitis, and rare occurrence of retinal breaks or detachment that responded well to intravenous acyclovir, with or without oral prednisolone. We report a case of unilateral ARN with marked vitritis and retinal necrosis leading to retinal breaks following chickenpox in a 32-year-old healthy lady. This patient was successfully treated with intravenous acyclovir followed by oral acyclovir and orbital floor triamcinolone injections to contain the inflammation with barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity, and to our knowledge, orbital floor triamcinolone therapy was not used earlier to contain ARN inflammation.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Dexamethasone; Drug Therapy, Combination; Eye Infections, Viral; Female; Glucocorticoids; Humans; Parasympatholytics; Retinal Necrosis Syndrome, Acute; Treatment Outcome; Triamcinolone; Tropanes; Visual Acuity

2007
Chickenpox in pregnancy: revisited.
    Reproductive toxicology (Elmsford, N.Y.), 2006, Volume: 21, Issue:4

    Varicella infection during the first and second trimester of pregnancy may increase the risk for congenital varicella syndrome 0.5-1.5% above the baseline risk for major malformation. Third trimester infection may lead to maternal pneumonia which can be life threatening if not treated appropriately. Varicella-zoster immune globulin (VZIG) should be administered as soon as possible preferably within 96 h from exposure to prevent maternal infection or subsequent complications. Later than 96 h, the effectiveness of VZIG has not been evaluated. Neonatal varicella is more severe if maternal rash appears 5 days prior to or 2 days after delivery. The newborn should be given VZIG immediately. Intravenous acyclovir is recommended for maternal pneumonia and severely affected neonate. No controlled study has yet evaluated the effectiveness of acyclovir or valacyclovir for postexposure prophylaxis to pregnant women or neonates. Unlike primary varicella infection in pregnancy, herpes zoster has not been documented to cause complications unless in the disseminated form. The advent of advanced imaging techniques and molecular biotechniques has improved prenatal diagnosis. With increase use of vaccination, the incidence of chickenpox in pregnancy is expected to decline in the future.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Fetal Diseases; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious

2006
[Varicella-zoster virus infections. 1: Chickenpox and shingles. Treatment and prevention].
    MMW Fortschritte der Medizin, 2006, Volume: Spec no.1

    Topics: Acyclovir; Adolescent; Adult; Age Factors; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Diagnosis, Differential; Female; Herpes Zoster; Herpes Zoster Ophthalmicus; Herpes Zoster Oticus; Herpesvirus 3, Human; Herpesvirus Vaccines; Humans; Infant; Infant, Newborn; Male; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Time Factors; Vaccination

2006
Varicella.
    Lancet (London, England), 2006, Oct-14, Volume: 368, Issue:9544

    Varicella-zoster virus, a herpesvirus, causes varicella (chickenpox) and, after endogenous reactivation, herpes zoster (shingles). Varicella, which is recognised by a characteristic vesicular rash, arises mainly in young children, although older individuals can be affected. In immunocompetent patients, symptoms are usually mild to moderate, but an uncomplicated severe case can have more than 1000 lesions and severe constitutional symptoms. Serious complications--including central nervous system involvement, pneumonia, secondary bacterial infections, and death--are sometimes seen. Varicella can be prevented by vaccination. Vaccine is about 80-85% effective against all disease and highly (more than 95%) effective in prevention of severe disease. In the USA, a routine childhood immunisation programme has reduced disease incidence, complications, hospital admissions, and deaths in children and in the general population, indicating strong herd immunity. Similar immunisation programmes have been adopted by some other countries, including Uruguay, Germany, Taiwan, Canada, and Australia, and are expected to be implemented more widely in future.

    Topics: Acyclovir; Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Viral; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Humans; Incidence; Infant

2006
Prevention of VZV infection in immunosuppressed patients using antiviral agents.
    Herpes : the journal of the IHMF, 2006, Volume: 13, Issue:3

    Antiviral agents play a key role in the prevention and treatment of varicella zoster virus (VZV) disease in immunosuppressed patients. Randomized trials show that aciclovir is effective in preventing VZV reactivation disease; however, no consensus exists on dose, duration and patient population for its use. The recent shortage of VZV-specific immunoglobulin has generated renewed interest in the use of antiviral agents as post-exposure prophylaxis. The use of antiviral agents for post-exposure prophylaxis is not supported by randomized trials, but uncontrolled experience suggests that it might be a reasonable alternative if varicella-specific immunoglobulin is not available. Current evidence on the use of antiviral agents in the prevention of reactivation disease and management of exposure to VZV is discussed.

    Topics: Acyclovir; Antiviral Agents; Chemoprevention; Chickenpox; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Valacyclovir; Valine; Virus Activation

2006
Retinitis following varicella in a vaccinated child with acute lymphoblastic leukemia.
    Pediatric blood & cancer, 2005, Volume: 45, Issue:2

    Serious ocular disease following varicella (chickenpox) is rare in children. In addition, retinitis in children with hematologic malignancies may present a difficult diagnostic challenge because infectious retinitis may mimic leukemic involvement of the eye. We report a 7-year-old patient with T-cell acute lymphoblastic leukemia in remission who presented with visual complaints 2 weeks after developing chickenpox. Ophthalmologic evaluation revealed acute retinitis in the right eye. Prolonged therapy with acyclovir resulted in near complete recovery. Early diagnosis of VZV retinopathy and aggressive antiviral treatment is critical to prevent acute and long-term ocular sequelae.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Diagnosis, Differential; Humans; Leukemia, T-Cell; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Retinitis

2005
Should acyclovir be prescribed for immunocompetent children presenting with chickenpox?
    Archives of disease in childhood, 2005, Volume: 90, Issue:6

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Evidence-Based Medicine; Female; Humans; Immunocompetence

2005
HIV: prevention of opportunistic infections.
    Clinical evidence, 2005, Issue:13

    Topics: 2-Aminopurine; Acyclovir; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Anti-HIV Agents; Antifungal Agents; Antitubercular Agents; Antiviral Agents; Azithromycin; Chickenpox; Clarithromycin; Cytomegalovirus Infections; Drug Therapy, Combination; Famciclovir; Ganciclovir; Herpes Simplex; Humans; Mycobacterium avium-intracellulare Infection; Mycoses; Pneumonia, Pneumocystis; Rifabutin; Toxoplasmosis; Trimethoprim, Sulfamethoxazole Drug Combination; Tuberculosis, Pulmonary

2005
Chickenpox, pregnancy and the newborn.
    Drug and therapeutics bulletin, 2005, Volume: 43, Issue:9

    In the UK, chickenpox (primary varicella virus infection) is usually a mild, self-limiting disease of childhood. It is more severe in adults. For example, of every 100,000 people who contract chickenpox, around 4-9 die from it, of whom 81-85% are adults. Chickenpox infection in pregnant women can lead to a severe maternal illness and it appears five times more likely to be fatal than in non-pregnant women. Although most women who have chickenpox in pregnancy give birth to healthy children, in other cases, the baby is harmed by in-utero infection or severe varicella of the newborn. Here we review the risks and key aspects of diagnosis and further management of varicella infection in pregnancy and the neonatal period.

    Topics: Acyclovir; Antiviral Agents; Breast Feeding; Chickenpox; Counseling; Female; Humans; Immune Sera; Infant, Newborn; Infectious Disease Transmission, Vertical; Pregnancy; Pregnancy Complications, Infectious; Referral and Consultation; Risk Factors

2005
Acyclovir for treating varicella in otherwise healthy children and adolescents.
    The Cochrane database of systematic reviews, 2005, Oct-19, Issue:4

    Acyclovir has the potential to shorten the course of illness which may result in reduced costs and morbidity associated with chickenpox.. 1) To examine the evidence evaluating the efficacy of acyclovir in alleviating symptoms of chickenpox and shortening the duration of illness. 2) To examine complications of chickenpox and adverse effects associated with acyclovir as reported in the relevant trials.. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2, 2005), MEDLINE (January 1966 to June 2005), and EMBASE (1988 to June 2005). The reference lists of all relevant articles were reviewed. The primary author of relevant studies and the pharmaceutical company that manufactures acyclovir were contacted.. Randomized controlled trials that evaluated otherwise healthy children zero to 18 years of age, with chickenpox.. Two authors independently reviewed the studies for eligibility. Two authors independently assessed methodological quality of the relevant studies using the Jadad scale and allocation concealment. Differences were resolved by consensus. Data were extracted by one author using a structured form and checked by a second. Continuous data were converted to the weighted mean difference (WMD). Weighted mean differences were combined into an overall estimate using random effects. There were too few studies to consider exploring statistical heterogeneity between studies (i.e., differences in reported effects), formally, or to assess for publication bias.. Three studies were included. Study quality was three (n = 2) and four (n = 1) on the Jadad scale. Acyclovir was associated with a reduction in the number of days with fever (-1.1 days, 95% CI -1.3 to -0.9) and in reducing the maximum number of lesions (-76 lesions, -145 to -8). Results were less supportive with respect to the number of days to no new lesions and the number of days to the relief of itching. There were no clinically important differences between acyclovir and placebo with respect to complications associated with chickenpox or adverse effects associated with the treatment.. Acyclovir appears to be effective in reducing the number of days with fever and the maximum number of lesions among otherwise healthy children with chickenpox. The results were less convincing with respect to the number of days to no new lesions and relief of itchiness. The clinical importance of acyclovir treatment in otherwise healthy children remains uncertain.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Humans; Randomized Controlled Trials as Topic

2005
Chickenpox.
    Clinical evidence, 2005, Issue:14

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Humans; Immune Sera; Immunization, Passive; Immunocompromised Host

2005
[Prophylaxis and treatment of viral infections. Part I--infections caused by DNA viruses].
    Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego, 2005, Volume: 18, Issue:104

    The amount of antiviral drugs have increased recently. Many viruses treated as a mild pathogens has turned out to cause different complications and severe diseaseses in elderly people and immunocomprised patients. The authors have made an attempt of presenting on the basis of scientific reports the principles of antiviral prophylaxis and treatment. The first part is focused on infections caused by DNA viruses.

    Topics: Acyclovir; Aged; Antiviral Agents; Chickenpox; DNA Viruses; Female; Herpes Zoster; Humans; Male; Vaccination; Virus Diseases

2005
Acyclovir for treating varicella in otherwise healthy children and adolescents.
    The Cochrane database of systematic reviews, 2004, Issue:2

    Acyclovir has the potential to shorten the course of illness which may result in reduced costs and morbidity associated with chickenpox.. 1) To examine the evidence evaluating the efficacy of acyclovir in alleviating symptoms of chickenpox and shortening the duration of illness. 2) To examine complications of chickenpox and adverse effects associated with acyclovir as reported in the relevant trials.. We searched The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1, 2003), MEDLINE (January 1966 to May 2003), and EMBASE (1988 to April 2003). The reference lists of all relevant articles were reviewed. The primary author of relevant studies and the pharmaceutical company that manufactures acyclovir were contacted.. Randomized controlled trials that evaluated otherwise healthy children zero to 18 years of age, with chickenpox.. Two reviewers independently reviewed the studies for eligibility. Two reviewers independently assessed methodological quality of the relevant studies using the Jadad scale and allocation concealment. Differences were resolved by consensus. Data were extracted by one reviewer using a structured form and checked by a second.Continuous data were converted to the weighted mean difference (WMD). Weighted mean differences were combined into an overall estimate using random effects. There were too few studies to consider exploring statistical heterogeneity between studies (i.e., differences in reported effects), formally, or to assess for publication bias.. Three studies were included. Study quality was three (n = 2) and four (n = 1) on the Jadad scale. Acyclovir was associated with a reduction in the number of days with fever (-1.1 days, 95% CI -1.3 to -0.9) and in reducing the maximum number of lesions (-76 lesions, -145 to -8). Results were less supportive with respect to the number of days to no new lesions and the number of days to the relief of itching. There were no clinically important differences between acyclovir and placebo with respect to complications associated with chickenpox or adverse effects associated with the treatment.. Acyclovir appears to be effective in reducing the number of days with fever and the maximum number of lesions among otherwise healthy children with chickenpox. The results were less convincing with respect to the number of days to no new lesions and relief of itchiness. The clinical importance of acyclovir treatment in otherwise healthy children remains controversial.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Humans; Randomized Controlled Trials as Topic

2004
Chickenpox.
    Clinical evidence, 2004, Issue:11

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Humans; Immune Sera; Immunization, Passive; Immunocompromised Host

2004
Chickenpox.
    Clinical evidence, 2004, Issue:12

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Humans; Immune Sera; Immunization, Passive; Immunocompromised Host

2004
[Varicella-zoster virus infection].
    Nihon rinsho. Japanese journal of clinical medicine, 2003, Volume: 61 Suppl 2

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Diagnosis, Differential; Herpes Zoster; Herpesvirus 3, Human; Humans

2003
Chickenpox.
    Clinical evidence, 2003, Issue:9

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Humans; Immune Sera; Immunization, Passive; Infant

2003
Varicella.
    Pediatrics in review, 2003, Volume: 24, Issue:11

    Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Infant, Newborn; Injections, Intravenous; Male; Pregnancy; Pregnancy Complications, Infectious; Recurrence; Streptococcal Infections

2003
HIV: opportunistic infections.
    Clinical evidence, 2003, Issue:9

    Topics: Acyclovir; AIDS-Related Opportunistic Infections; Anti-HIV Agents; Anti-Infective Agents; Antitubercular Agents; Antiviral Agents; Atovaquone; Azithromycin; Chickenpox; Clarithromycin; Cytomegalovirus Infections; Drug Therapy, Combination; Ganciclovir; Herpes Simplex; Humans; Mycobacterium avium-intracellulare Infection; Naphthoquinones; Pneumonia, Pneumocystis; Rifabutin; Toxoplasmosis; Trimethoprim, Sulfamethoxazole Drug Combination; Tuberculosis, Pulmonary; Valacyclovir; Valine

2003
Antiviral therapy for varicella and herpes zoster.
    Seminars in pediatric infectious diseases, 2002, Volume: 13, Issue:1

    Varicella-zoster virus (VZV) causes 2 clinical illnesses, varicella (chickenpox) and herpes zoster (shingles). The purpose of this review is to describe the role of antiviral therapy in the treatment of VZV infections in healthy and immunocompromised children. Acyclovir is the drug of choice for varicella and herpes zoster. The route of administration may be intravenous or oral, depending on the immunocompetence of the host. The clinical impact of acyclovir therapy is related directly to its use early in the clinical course and to the likely susceptibility of the patient to severe or life-threatening VZV infection. Patients who have the most clinical benefit are otherwise healthy adolescents with varicella infection and high-risk populations of immunocompromised children who have varicella or herpes zoster. The morbidity and mortality of VZV infections are reduced substantially by initiating acyclovir treatment early in the course of the disease.

    Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Algorithms; Antiviral Agents; Chickenpox; Child; Child, Preschool; Clinical Trials as Topic; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Infant; Infant, Newborn; Injections, Intravenous; Time Factors

2002
Chickenpox.
    Clinical evidence, 2002, Issue:7

    Topics: Acyclovir; Administration, Oral; Adult; AIDS-Related Opportunistic Infections; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Dose-Response Relationship, Drug; Humans; Immunization, Passive; Infant; Infant, Newborn; Infusions, Intravenous; Prognosis

2002
Antiviral agents: Non-antiretroviral [correction of Nonantiviral] drugs.
    Journal of the American Academy of Dermatology, 2002, Volume: 47, Issue:4

    The current arsenal of antiviral agents available to the practitioner is expanding rapidly, such that by the time this article goes to press, new drugs may have already been added. Although the majority of approved drugs have been developed for use in only a few viral infections (eg, HIV, herpesviruses, and papillomavirus), discoveries made in the development of these drugs may lead to antiviral agents effective against other viruses. In addition, new uses for the currently available drugs are under evaluation. This review of antiviral agents discusses the treatments available for viral infections such as herpes simplex virus, varicella zoster virus, cytomegalovirus, human papillomavirus, chronic viral hepatitis, and others.

    Topics: 2-Aminopurine; Acyclovir; Antiviral Agents; Chickenpox; Cytomegalovirus Infections; Famciclovir; Foscarnet; Guanine; Hepatitis B; Hepatitis C; Herpes Genitalis; Herpes Simplex; Herpesvirus 3, Human; Herpesvirus 8, Human; Humans; Papillomavirus Infections; Sarcoma, Kaposi; Skin Diseases, Viral; Valacyclovir; Valine

2002
Acyclovir for treating varicella in otherwise healthy children and adolescents: a systematic review of randomised controlled trials.
    BMC pediatrics, 2002, Sep-30, Volume: 2

    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.. 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.. 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 pruritus. There were no clinically important differences between acyclovir and placebo with respect to complications or adverse effects.. 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.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Fever; Humans; Randomized Controlled Trials as Topic; Time Factors

2002
Acyclovir for treating varicella in otherwise healthy children and adolescents.
    The Cochrane database of systematic reviews, 2002, Issue:4

    Acyclovir has the potential to shorten the course of illness which may result in reduced costs and morbidity.. 1) To examine the evidence evaluating the efficacy of acyclovir in alleviating symptoms and shortening the duration of illness. 2) To examine complications of chickenpox and adverse effects associated with acyclovir as reported in the relevant trials.. We searched the Cochrane Controlled Trials Register (2002, Issue 2), MEDLINE (January 1966 to October 2001), EMBASE (1988 to September 2001). The reference lists of all relevant articles were reviewed. The primary author of relevant studies and the pharmaceutical company that manufactures acyclovir were contacted.. Randomized controlled trials that evaluated otherwise healthy children 0-18 years of age with chickenpox.. Two reviewers independently reviewed the studies for eligibility. Two reviewers independently assessed methodological quality of the relevant studies using the Jadad scale and allocation concealment. Differences were resolved by consensus. Data were extracted by one reviewer using a structured form and checked by a second. Continuous data were converted to the weighted mean difference (WMD). Weighted mean differences were not combined into an overall estimate due to the varied age groups between studies. There were too few studies to consider statistical heterogeneity between studies (i.e., differences in reported effects), to perform subgroup or sensitivity analyses, or to assess for publication bias.. Three studies were included. Study quality was three (n=2) and four (n=1) on the Jadad scale. Acyclovir was associated with a 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 the number of days to the relief of itching. There were no clinically important differences between acyclovir and placebo with respect to complications associated with chickenpox or adverse effects associated with the drug.. 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, relief of itchiness and maximum number of lesions. The clinical importance of acyclovir treatment in otherwise healthy children remains controversial.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Child, Preschool; Humans; Randomized Controlled Trials as Topic

2002
Chickenpox.
    Clinical evidence, 2002, Issue:8

    Topics: Acyclovir; Administration, Oral; Adult; AIDS-Related Opportunistic Infections; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Dose-Response Relationship, Drug; Humans; Immunization, Passive; Infant; Infant, Newborn; Infusions, Intravenous; Prognosis

2002
Genvir (Flamel Technologies).
    Current opinion in investigational drugs (London, England : 2000), 2001, Volume: 2, Issue:5

    Flamel Technologies is developing Genvir (formerly known as Viropump), a twice-daily controlled-release formulation of aciclovir, for potential use in the treatment of herpes simplex virus and varicella zoster virus infections. Genvir utilizes Flamel's proprietary Micropump technology, a microparticle-based drug delivery system designed to extend the time of absorption of drugs in the small intestine. The drug shows a comparable therapeutic efficacy to valaciclovir and famciclovir (both GlaxoSmithKline) [313393]. Phase III trials have been completed [302829]. In August 2000, Flamel filed for regulatory approval for the treatment of herpes in France, as a prelude to a pan-European approval [378641] and is preparing an IND application to begin clinical trials for genital herpes in the US [245970].

    Topics: Acyclovir; Animals; Antiviral Agents; Chickenpox; Enzyme Inhibitors; Herpes Simplex; Humans; Nucleic Acid Synthesis Inhibitors; Thymidine Kinase

2001
[Antiviral prophylaxis].
    Klinische Padiatrie, 2001, Volume: 213 Suppl 1

    Antiviral prophylaxis in pediatric oncology and pediatric bone marrow transplantation (BMT)/stem cell transplantation (SCT) focuses herpes viruses: herpes simplex virus (HSV), varicella zoster virus (VZV) and cytomegalovirus (CMV) since these viruses cause significant morbidity and mortality due to primary infection or to reactivation in long term latency. The majority of studies on antiviral prophylaxis, especially those on CMV-prophylaxis, have been conducted in adult patients. Recommendations for antiviral prophylaxis have been published recently by the German "Deutsche Gesellschaft für pädiatrische Infektiologie" and by the following American institutions and societies "Centers for Disease Control and Prevention", "Infectious Diseases Society of America", "American Society of Blood and Marrow Transplantation" who published the "Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients". Concerning HSV- and VZV-prophylaxis there are almost no differences between recommendations of the german society and the american institutions, however recommendations for preventing CMV-disease and CMV-recurrence do differ considerably. Controversial aspects of antiviral prophylaxis, e.g. VZV vaccination or CMV prevention, should be studied in oncology and infectious diseases working groups to define consensus in the near future.

    Topics: Acyclovir; Adult; Age Factors; Antiviral Agents; Bone Marrow Transplantation; Chickenpox; Child; Cytomegalovirus Infections; Ganciclovir; Hematopoietic Stem Cell Transplantation; Herpes Simplex; Humans; Immunization, Passive; Neoplasms; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Recurrence; Time Factors; Viral Vaccines; Virus Diseases

2001
Concurrent myelitis and Guillain-Barré syndrome after varicella infection.
    International journal of clinical practice, 2001, Volume: 55, Issue:9

    Myelitis and Guillain-Barré syndrome occurring concurrently after varicella infection is very rare. A 34-year-old man presented with progressive flaccid tetraparesis, facial palsy, respiratory failure, sensory loss and urinary incontinence one week after varicella infection. Clinical, imaging and electrodiagnostic studies supported the diagnosis of myelitis and Guillain-Barré syndrome. He improved with intravenous acyclovir and gammaglobulin.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Electrophysiology; Globins; Guillain-Barre Syndrome; Humans; Magnetic Resonance Imaging; Male; Myelitis; Spinal Cord

2001
Neonatal varicella.
    Journal of perinatology : official journal of the California Perinatal Association, 2001, Volume: 21, Issue:8

    Neonatal varicella is mostly caused by maternal chickenpox acquired during the last 3 weeks of pregnancy. Transplacentally transmitted infections occur in the first 10 to 12 days of life, whereas chickenpox after that time is most likely acquired by postnatal infection. If the mother develops rash between days 4 and 5 antepartum to day 2 postpartum, generalized neonatal varicella leading to death occurs in up to 20% of affected cases. Neonatal chickenpox within the first 4 days after birth has usually been found to be mild. A fatal outcome has been reported in 23% of cases if neonatal chickenpox occurs between 5 and 10 to 12 days of age. Serological methods have been widely used to confirm clinical diagnosis. For rapid virological diagnostics, amplification of viral DNA in skin swabs by polymerase chain reaction is the method of choice. To prevent severe neonatal chickenpox, passive immunization is indicated. If varicella occurs, acyclovir treatment has to be administered promptly.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Humans; Immunization, Passive; Infant, Newborn; Infectious Disease Transmission, Vertical; Pregnancy; Pregnancy Complications, Infectious; Prognosis

2001
Prevention and treatment of VZV infections in patients with HIV.
    Herpes : the journal of the IHMF, 2001, Volume: 8, Issue:2

    Varicella zoster virus (VZV) infections in human immunodeficiency virus (HIV)-infected patients are known to have a different disease spectrum from that seen in other types of patients. Varicella in children with HIV infection is likely to be more serious than in otherwise healthy children and routine antiviral therapy is recommended. There is evidence that the development of varicella in HIV-infected children is not associated with progression to AIDS, suggesting that it may be safe to immunize HIV-infected children with live attenuated varicella vaccine. There are no published data on varicella in HIV-infected adults, however, probably because most adults have already experienced varicella prior to HIV infection. Zoster in HIV-infected children differs somewhat from that in HIV-infected adults. In particular, HIV-infected children who develop varicella in the setting of severe immunodeficiency are at an especially high risk to develop zoster. Given the low rate of toxicity of aciclovir as well as its ease of administration and its efficacy in hastening the healing of VZV infections, prompt treatment with this antiviral agent is recommended for both HIV-infected children and adults. Foscarnet should be used for zoster that is strongly suspected or proven to be caused by aciclovir-resistant VZV. Patients with HIV for whom there is no evidence of significant immunosuppression and who have not had varicella should be immunized with live attenuated varicella vaccine as a preventative measure for both varicella and zoster. It is hoped that immunization of VZV seropositive HIV-infected patients will decrease the incidence of zoster. Studies to determine this are under way.

    Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Foscarnet; Herpesvirus 3, Human; Humans; Prospective Studies; Risk Factors

2001
Other smoking-affected pulmonary diseases.
    Clinics in chest medicine, 2000, Volume: 21, Issue:1

    Cigarette smoking is the leading cause of preventable death in the United States. Smoking adversely affects many organ systems, but especially the lung. Carcinoma of the lung and chronic obstructive pulmonary disease account for most smoking-associated respiratory morbidity and mortality, and their association with smoking is both well established and widely recognized. Cigarette smoking also is associated with differences in the incidence, severity, or natural history of a broad array of other respiratory illnesses, ranging from the common cold to pneumothorax, pulmonary hemorrhage, and various interstitial lung diseases. Interestingly, while the general effect of smoking on respiratory diseases is adverse, in the cases of sarcoidosis and hypersensitivity pneumonitis smoking may actually be associated with a decrease in the incidence of disease. In this article, the author briefly discusses some of the pulmonary and systemic effects of smoking that might mediate its effects on an array of lung diseases, then comprehensively reviews less common or less well-recognized smoking-affected lung diseases such as pulmonary infections, spontaneous pneumothorax, Goodpasture's syndrome, eosinophilic granuloma and other interstitial lung diseases, and pulmonary metastatic disease.

    Topics: Acyclovir; Alveolitis, Extrinsic Allergic; Antiviral Agents; Arthritis, Rheumatoid; Asbestosis; Bronchiolitis; Chickenpox; Eosinophilic Granuloma; Humans; Lung Diseases; Lung Neoplasms; Pneumonia, Bacterial; Pneumonia, Viral; Pneumothorax; Pulmonary Fibrosis; Respiratory Tract Infections; Risk Factors; Smoking

2000
[Varicella and pregnancy].
    Duodecim; laaketieteellinen aikakauskirja, 2000, Volume: 116, Issue:19

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Congenital Abnormalities; Female; Fetal Diseases; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Pregnancy; Pregnancy Complications, Infectious; Prenatal Diagnosis

2000
Management of varicella-zoster virus infections in children.
    Advances in experimental medicine and biology, 1999, Volume: 458

    The introduction of varicella vaccine for immunization of healthy children is expected to have a gradual impact on the incidence of VZV infections in the population but antiviral therapy remains an important intervention in clinical practice. The efficacy of aciclovir for treatment of primary and recurrent VZV infections in children has reduced the morbidity and mortality of these illnesses in immunocompromised children dramatically. Oral aciclovir is an effective and useful for the management of varicella in healthy children and adolescents.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Herpes Zoster; Humans; Immunocompromised Host

1999
[Varicella pneumonia: the complications of antiviral treatment].
    Archivos de bronconeumologia, 1999, Volume: 35, Issue:9

    Topics: Acute Disease; Acyclovir; Antiviral Agents; Chickenpox; Humans; Male; Middle Aged; Pneumonia, Viral; Respiratory Insufficiency

1999
Chickenpox (varicella).
    Contributions to microbiology, 1999, Volume: 3

    Topics: Acyclovir; Animals; Antiviral Agents; Chickenpox; Child; Clinical Trials as Topic; Herpesvirus 3, Human; Humans; Immunocompromised Host

1999
Approaches to the treatment of varicella-zoster virus infections.
    Contributions to microbiology, 1999, Volume: 3

    Topics: 2-Aminopurine; Acyclovir; Adrenal Cortex Hormones; Antiviral Agents; Chickenpox; Famciclovir; Guanine; Herpes Zoster; Humans; Immunocompromised Host; Prodrugs; Valacyclovir; Valine

1999
[Varicella and zona: epidemiology, physiopathology, diagnosis, course, treatment].
    La Revue du praticien, 1999, Nov-15, Volume: 49, Issue:18

    Topics: 2-Aminopurine; Acyclovir; Adult; Aged; Antiviral Agents; Chickenpox; Child; Child, Preschool; Diagnosis, Differential; Famciclovir; Female; Herpes Zoster; Herpes Zoster Ophthalmicus; Herpes Zoster Oticus; Humans; Immunocompromised Host; Infant; Infant, Newborn; Male; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Prodrugs; Valacyclovir; Valine

1999
Antiviral prophylaxis and treatment in chickenpox. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection.
    The Journal of infection, 1998, Volume: 36 Suppl 1

    Prophylactic intervention with varicella-zoster immunoglobulin early in the incubation period can prevent or attenuate the disease manifestations of varicella in susceptible contacts at high risk from this infection. Detailed guidelines are issued in the UK Department of Health publication on Immunization against Infectious Disease. Sensitive immunoassays are available for investigation of antibody status and subclinical seroconversion. Live attenuated varicella vaccine, which has been used successfully post-exposure as well as electively elsewhere, is at present not generally available in the UK. Effective protocols for prophylaxis against varicella with the antiviral agent aciclovir are not yet established. The nucleoside analogue aciclovir (syn: acyclovir, Zovirax) is effective in inhibiting replication of VZV when given at a dosage higher than that required for treatment of HSV, and is currently the only available and approved treatment for varicella in the U.K. Intravenous aciclovir therapy for 5-10 days is effective for varicella in neonates and the immunocompromised, and for varicella pneumonia or other complications in adults and children, if begun early. Oral aciclovir is only effective if begun with 24 h of onset of rash. With that proviso. it is recommended for treatment of varicella in otherwise healthy adults and adolescents, but not for routine use in children under 13 years of age unless they are sibling contacts or have other medical conditions. Aciclovir has a high therapeutic index and good safety profile, but caution is advised with use in pregnancy.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Female; Herpesvirus 3, Human; Humans; Immunization, Passive; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious

1998
Chickenpox in childhood. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection.
    The Journal of infection, 1998, Volume: 36 Suppl 1

    Chickenpox in childhood is a milder condition than in older patients, but serious and even fatal complications may occur. These occur especially in immunosuppressed individuals, but can also be seen in normal children. The commonest of these is secondary bacterial infection with staphylococci or streptococci. Reye's syndrome is now rare in chickenpox, since aspirin no longer used in treatment. Aciclovir and VZIG (varicella zoster immune globulin) have a role in the management of chickenpox in the immunosuppressed or immunodeficient child, and aciclovir may be valuable in managing some normal children. Chickenpox should not always be considered a trivial illness.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Female; Humans; Immune Sera; Immunization, Passive; Immunocompetence; Immunocompromised Host; Male

1998
Management of chickenpox in the adult. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection.
    The Journal of infection, 1998, Volume: 36 Suppl 1

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Immune Sera; Immunocompetence; Immunocompromised Host; Male; Pregnancy; Pregnancy Complications, Infectious

1998
Antiviral drugs in healthy children.
    American family physician, 1998, Mar-01, Volume: 57, Issue:5

    Several antiviral agents are available to treat viral illnesses in healthy children. In some children, treatment with acyclovir is an alternative to vaccination for the treatment and prevention of chickenpox. Acyclovir also can be useful in the treatment or prevention of herpes simplex infections in neonates. Ribavirin, once recommended as routine therapy for high-risk infants with respiratory syncytial virus disease, is now reserved for use in selected children. Amantadine and rimantidine are effective against influenza type A and can be used to protect children from influenza, as well as to lessen the duration and severity of illness in those who are already ill.

    Topics: Acyclovir; Amantadine; Antiviral Agents; Chickenpox; Child; Child, Preschool; Drug Administration Schedule; Herpes Simplex; Humans; Respiratory Syncytial Virus Infections; Ribavirin; Rimantadine; Virus Diseases

1998
[Treatment of varicella].
    Presse medicale (Paris, France : 1983), 1997, Volume: 26 Suppl 1

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Child; Humans; Immunocompetence; Immunocompromised Host

1997
Management of herpes simplex and varicella-zoster virus infections.
    The Western journal of medicine, 1997, Volume: 166, Issue:3

    Herpes simplex virus and varicella-zoster virus are common infections and are seen frequently in clinical practice. Infection with these viruses results in cutaneous lesions that may be diagnosed clinically, but widely available laboratory testing is useful for confirmation. Asymptomatic herpes simplex virus shedding, or "subclinical reactivation," likely occurs in all persons infected with herpes simplex virus and results in the transmission of virus despite the absence of signs or symptoms that suggest active infection. Oral and intravenous acyclovir are effective in treating initial and recurrent herpes simplex and varicella-zoster virus infections. The daily administration of oral acyclovir as suppressive therapy is effective in patients with frequently recurring genital infection with herpes simplex virus by reducing the number of symptomatic recurrences and the frequency of asymptomatic virus shedding. Two new antiviral agents, famciclovir and valacyclovir hydrochloride, have been approved for the short-term treatment of recurrent genital herpes simplex virus and recurrent zoster in nonimmunocompromised hosts. Famciclovir and valacyclovir demonstrate superior pharmacokinetics compared with acyclovir and allow for less frequent daily dosing with higher achievable serum drug concentrations. The attenuated live varicella virus vaccine is now available in the United States and prevents primary varicella-zoster virus infection in susceptible children and adults.

    Topics: 2-Aminopurine; Acyclovir; Adult; Antiviral Agents; Chickenpox; Child; Famciclovir; Female; Herpes Simplex; Herpes Zoster; Humans; Male; United States; Valacyclovir; Valine

1997
Antiviral therapy of herpes simplex and varicella-zoster virus infections.
    Intervirology, 1997, Volume: 40, Issue:5-6

    Antiviral treatment of herpesvirus infections is rapidly changing since the advent of new drugs with improved oral availability. The efficacy of valaciclovir, the prodrug of aciclovir, and famciclovir, the prodrug of penciclovir, in the treatment of herpes genitalis and acute herpes zoster has been well documented in large clinical trials. Both drugs are effective on zoster-associated pain. Brivudin and sorivudine which are the most active compounds against varicella-zoster virus (VZV) in cell culture have also been successful in the treatment of herpes zoster. Aciclovir is still the standard therapy of severe herpes simplex virus (HSV) and varicella virus infections. In patients treated with aciclovir, the mortality of herpes encephalitis has been reduced to about 25%. The development of resistance against aciclovir and the other nucleoside analogues has not been a problem to date in the treatment of immunocompetent individuals. However, in immunocompromised patients, aciclovir-resistant HSV strains often emerge. In such cases, intravenous foscarnet is the current treatment of choice.

    Topics: 2-Aminopurine; Acyclovir; Administration, Oral; Antiviral Agents; Arabinofuranosyluracil; Bromodeoxyuridine; Chickenpox; Drug Resistance, Microbial; Encephalitis, Viral; Famciclovir; Herpes Genitalis; Herpes Labialis; Herpes Simplex; Herpes Zoster; Humans; Immunocompromised Host; Prodrugs; Simplexvirus; Valacyclovir; Valine

1997
Acyclovir therapy in chickenpox.
    Indian pediatrics, 1996, Volume: 33, Issue:4

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Child, Preschool; Developing Countries; Humans; India; Treatment Outcome

1996
Varicella-zoster virus.
    Clinical microbiology reviews, 1996, Volume: 9, Issue:3

    Varicella-zoster virus (VZV) is a ubiquitous human alphaherpesvirus that causes varicella (chicken pox) and herpes zoster (shingles). Varicella is a common childhood illness, characterized by fever, viremia, and scattered vesicular lesions of the skin. As is characteristic of the alphaherpesviruses, VZV establishes latency in cells of the dorsal root ganglia. Herpes zoster, caused by VZV reactivation, is a localized, painful, vesicular rash involving one or adjacent dermatomes. The incidence of herpes zoster increases with age or immunosuppression. The VZV virion consists of a nucleocapsid surrounding a core that contains the linear, double-stranded DNA genome; a protein tegument separates the capsid from the lipid envelope, which incorporates the major viral glycoproteins. VZV is found in a worldwide geographic distribution but is more prevalent in temperate climates. Primary VZV infection elicits immunoglobulin G (IgG), IgM, and IgA antibodies, which bind to many classes of viral proteins. Virus-specific cellular immunity is critical for controlling viral replication in healthy and immunocompromised patients with primary or recurrent VZV infections. Rapid laboratory confirmation of the diagnosis of varicella or herpes zoster, which can be accomplished by detecting viral proteins or DNA, is important to determine the need for antiviral therapy. Acyclovir is licensed for treatment of varicella and herpes zoster, and acyclovir, valacyclovir, and famciclovir are approved for herpes zoster. Passive antibody prophylaxis with varicella-zoster immune globulin is indicated for susceptible high-risk patients exposed to varicella. A live attenuated varicella vaccine (Oka/Merck strain) is now recommended for routine childhood immunization.

    Topics: Acyclovir; Antibody Formation; Antiviral Agents; Chickenpox; Contraindications; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunity, Cellular; Immunization, Passive; Serology; Vaccination; Vaccines, Attenuated

1996
Treatment of acyclovir-resistant herpes simplex and varicella zoster virus infections.
    Advances in experimental medicine and biology, 1996, Volume: 394

    Topics: Acyclovir; Animals; Antiviral Agents; Chickenpox; Drug Resistance, Microbial; Herpes Simplex; Herpesvirus 3, Human; Humans; Simplexvirus

1996
Acyclovir for the prevention and treatment of varicella zoster in children, adolescents and pregnancy.
    Journal of paediatrics and child health, 1996, Volume: 32, Issue:3

    Varicella causes a mild, self-limiting childhood disease that may reactivate years later as shingles. In immunocompromised patients with altered cell mediated immunity, and rarely in healthy individuals, varicella results in a life-threatening infection. The antiviral drug, acyclovir, substantially reduces the mortality and risk of severe disease in these groups of patients. Early commencement of acyclovir is recommended for children with both varicella and altered cell mediated immunity, newborns during the first 2 weeks of life, preterm infants in the neonatal nursery, and severe varicella or shingles (including ocular zoster) in any patient, as well as during pregnancy. Acyclovir may be considered in children with serious cardiopulmonary disease or chronic skin disorders where varicella may exacerbate the underlying disease or increase the risk of secondary bacterial sepsis. Acyclovir, however, is not recommended for healthy individuals without severe disease, as a prophylactic agent against varicella, for asthmatics receiving aerosolized or low-dose oral steroids and/or as treatment of the post-varicella syndromes. When acyclovir is prescribed it should be given intravenously to those with severe disease, those at risk of dissemination and in children younger than 2 years of age.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Treatment Outcome

1996
Primary varicella in adult renal transplant recipients: a report of three cases plus a review of the literature.
    Clinical transplantation, 1995, Volume: 9, Issue:2

    Disseminated primary varicella zoster infection in renal transplant patients can result in severe and often fatal illness. The disease tends to be much more severe in adults with an 80% mortality in the only reported series (1). We report 3 cases of severe disseminated varicella zoster in adult renal transplant patients who all survived. Early diagnosis, institution of intravenous acyclovir 10 mg/kg tds, zoster immunoglobulin, cessation of azathioprine treatment and aggressive supportive care may improve an otherwise bleak prognosis.

    Topics: Acyclovir; Adult; Azathioprine; Chickenpox; Disseminated Intravascular Coagulation; Female; Follow-Up Studies; Herpesvirus 3, Human; Humans; Immunoglobulins; Kidney Transplantation; Male

1995
Acyclovir for childhood chickenpox. Cost is unjustified.
    BMJ (Clinical research ed.), 1995, Jan-14, Volume: 310, Issue:6972

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Drug Costs; Humans

1995
[Prenatal diagnosis of fetal varicella in the second trimester of pregnancy].
    Journal de gynecologie, obstetrique et biologie de la reproduction, 1995, Volume: 24, Issue:8

    The first case of prenatal diagnosis of congenital varicella by amniotic fluid viral culture and PCR is reported. Chickenpox is a benign disease in children, but it can lead to severe complications in the adult, especially in the pregnant woman. Five percent of women in childbearing age are not immunised, and the incidence of gestational chickenpox is between 1 and 7 per 10,000. The consequences of this primary infection during pregnancy can be severe for the mother, because of the risk of serious varicella pneumonia, and for the fetus. The fetal infection depends on the gestational age at which the maternal infection occurs. The 2% evaluated risk of fetopathy is maximal between the 7th and 20th week of amenorrhoea. The reported congenital abnormalities are essentially cutaneous, neurological, ophthalmological and musculo-squeletal lesions. A prenatal diagnosis can be suggested: the revelation of defects by ultrasound scan confirms the fetal affection, and can justify pregnancy termination; on the other hand, amniocentesis and cordocentesis are not totally safe, and cannot always assert the fetal contamination or its level of affection. From the therapeutical point of view, prevention with polyvalent gamma-globulin is prescribed to non-immunised pregnant women who have been in contact with the virus. On the opposite, in case of contracted chickenpox, the treatment of the mother with an association of polyvalent gamma-globulin and acyclovir is still controversial since, although probably effective, it may not be safe for the fetus. The solution may reside in the vaccination, soon available, of non-immunised women in childbearing age.

    Topics: Acyclovir; Adult; Amniocentesis; Amniotic Fluid; Antiviral Agents; Chickenpox; Female; Fetal Diseases; gamma-Globulins; Humans; Incidence; Polymerase Chain Reaction; Pregnancy; Pregnancy Trimester, Second

1995
Recognition and treatment of shingles.
    Drugs, 1994, Volume: 48, Issue:4

    Varicella zoster virus (VZV) is responsible for a primary infection (varicella) followed by a latency, eventually resulting in herpes zoster (shingles). The replication cycle of VZV is normally interrupted after varicella. Consequently, VZV remains dormant in the organism. Reactivation occurs after viraemia, and the development of tissue alterations (skin and viscera) depends on the immunological status of the patient. Diagnosis of herpes zoster relies on clinical recognition and cytological and histological evaluations combined with immunohistochemistry and molecular biology techniques. Treatment of herpes zoster primarily relies upon antiviral drugs and incidentally on immunomodulating agents, specific immunoglobulins, antimicrobial agents, antiviral enzymes and corticosteroids. Drugs with a clinically relevant activity against varicella zoster virus infections include aciclovir, adenosine monophosphate, bromodeoxyuridine, desciclovir, fiacitabine, idoxuridine, interferon-alpha and vidarabine. Among them, aciclovir appears to be a first-line agent. Its efficacy has been well established by many clinical studies. Promising drugs for the future include famciclovir, penciclovir, valaciclovir and other molecules currently under investigation. Recent and promising improvements in antiviral drug development may increase patient compliance, cost-benefit ratios and therapeutic efficacy.

    Topics: Acyclovir; Adjuvants, Immunologic; Adrenal Cortex Hormones; Antiviral Agents; Arabinofuranosyluracil; Chickenpox; Herpes Zoster; Humans; Immunoglobulins; Virus Replication

1994
Successors to acyclovir.
    The Journal of antimicrobial chemotherapy, 1994, Volume: 34, Issue:3

    Topics: 2-Aminopurine; Acyclovir; Antiviral Agents; Arabinofuranosyluracil; Chickenpox; Drug Resistance, Microbial; Famciclovir; Herpes Simplex; Herpes Zoster; Humans; Valacyclovir; Valine

1994
Acyclovir. Is the honeymoon coming to an end?
    The Journal of infection, 1994, Volume: 28, Issue:2

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Antiviral Agents; Chickenpox; Cytomegalovirus Infections; Herpes Simplex; Humans

1994
Clinical aspects of chickenpox and herpes zoster.
    The Journal of international medical research, 1994, Volume: 22 Suppl 1

    Chickenpox in immunocompromised individuals is potentially fatal and should be treated with intravenous acyclovir as soon as it is recognized. Data from four double-blind, placebo-controlled trials in the USA provide a sound scientific basis for using acyclovir to treat chickenpox in immunocompetent individuals. Three studies in children and a fourth study in US naval recruits showed statistically significant reductions in the duration of fever, constitutional illness, and time to cutaneous healing, when treatment was initiated within 24 h of rash onset. Although chickenpox is generally mild in children the severity of the disease increases with age and secondary cases in the family tend to be more ill than the primary case. It is recommended that secondary and tertiary cases in a family, and adolescents and adults with chickenpox be treated with acyclovir. In immunocompromised hosts, intravenous acyclovir halts the progression of herpes zoster and is recommended as therapy during new lesion formation. Herpes zoster in otherwise normal hosts is rarely accompanied by visceral dissemination, but carries an increasing risk of post-herpetic neuralgia with increasing age. Published clinical trials have shown a reduction in the duration and severity of acute pain during herpes zoster for patients treated with acyclovir, but results for chronic pain are conflicting with some, but not all, studies showing a beneficial effect.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Child; Female; Herpes Zoster; Humans; Immunocompromised Host; Male; Pregnancy

1994
Varicella pneumonia: a case report and review.
    American family physician, 1994, Sep-15, Volume: 50, Issue:4

    A case of pneumonia complicating the course of chickenpox in a previously healthy man is presented. Serious impairment of gas exchange developed, requiring multidisciplinary intensive care management, mechanical ventilation and intravenous acyclovir therapy. Additional complications of hepatitis and pancreatitis occurred. Varicella pneumonia is a potentially life-threatening complication that should be suspected in any adult with chickenpox and respiratory symptoms.

    Topics: Acyclovir; Adult; Chickenpox; Humans; Male; Pneumonia

1994
[Varicella pneumonia in adults infected by HIV-1. Presentation of 2 cases].
    Enfermedades infecciosas y microbiologia clinica, 1994, Volume: 12, Issue:1

    Infection by the varicella-zoster virus (VZV) is frequent in patients infected by the HIV-1. Nonetheless, visceral involvement in addition to that of pneumonia is rare, despite the important immune dysfunction found among these patients.. Varicella pneumonia was diagnosed in 2 patients with HIV-1 infection who presented cough with high fever and a characteristic rash in addition to respiratory failure and a micronodular pattern on chest radiography. The medical literature is reviewed (MEDLINE).. An excellent clinical response was achieved with endovenous acyclovir treatment.. The authors underline how rare is varicella pneumonia in patients with HIV-1 infection. The appearance of a pustulous vesicular rash in the context of a febrile episode leads to suspicion of this diagnosis. The treatment of choice is endovenous acyclovir (5 mg/kg/8 h). Varicella pneumonia has also been described in children with HIV-1 infection. The possible increase in patients with varicella pneumonia with be assessed, due to the immunosuppressive state of these patients. Patients not having been in contact with the varicella-zoster virus are particularly susceptible to presenting primoinfection by this virus.

    Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Chickenpox; Female; HIV-1; Humans; Male; Pneumonia, Viral

1994
Oral acyclovir in immunocompetent patients with varicella.
    The Annals of pharmacotherapy, 1994, Volume: 28, Issue:2

    Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Chickenpox; Child; Child, Preschool; Double-Blind Method; Herpes Zoster; Humans; Immunocompetence; Randomized Controlled Trials as Topic

1994
Complete heart block in a child with varicella.
    The American journal of emergency medicine, 1993, Volume: 11, Issue:6

    A case of varicella myocarditis in a previously healthy 6-year-old child was reviewed. The patient presented with third-degree heart block and shock as the sole manifestation of her cardiac involvement. Bradyarrhythmias required temporary transvenous pacing. Intravenous acyclovir was used. The patient recovered without permanent sequelae. The natural history, clinical presentation, and treatment of varicella myocarditis are reviewed.

    Topics: Acyclovir; Bradycardia; Cardiac Pacing, Artificial; Chickenpox; Child; Electrocardiography; Female; Heart Block; Humans; Infusions, Intravenous; Isoproterenol; Myocarditis; Shock, Cardiogenic

1993
Current management of varicella zoster virus infections.
    Journal of medical virology, 1993, Volume: Suppl 1

    A series of randomized, placebo-controlled, double-blind clinical trials conducted from 1980 to the present provide the basis for appropriate management of varicella-zoster virus (VZV) infections. Placebo recipients in these studies have also provided valuable natural history data on the clinical course of VZV infections. The protocols in toto have shown acyclovir (ACV) to be safe and effective for treatment of nearly all forms of acute VZV infection. A number of issues still need to be addressed, including appropriate dosage, importance of early initiation of therapy, cost-benefit ratio, and viral resistance. Considering the data in aggregate, the author recommends ACV treatment for all acute VZV infections in immunocompromised hosts; for acute herpes zoster infections in all adults; and for varicella in otherwise healthy adults and adolescents, and children who contract it from a sibling.

    Topics: Acyclovir; Chickenpox; Herpes Zoster; Humans; Immunocompromised Host

1993
Acyclovir therapy for varicella in otherwise healthy children and adolescents.
    Journal of medical virology, 1993, Volume: Suppl 1

    Acyclovir has been approved in the United States and elsewhere as antiviral therapy for otherwise healthy children and adolescents with varicella. This development arose from multicentre placebo-controlled trials of acyclovir in normal patients, 2-18 years of age, which showed that the drug accelerated cutaneous healing, and reduced fever and related constitutional symptoms without harmful side effects. Acyclovir did not, however, decrease transmission of chickenpox within the household, nor was there any demonstrable effect of antiviral therapy on varicella complications. In this article, the background and rationale for the multicentre studies of acyclovir in normal paediatric patients with chickenpox is reviewed. The evidence for and against its routine administration within 24 hours of the eruption of skin rash is also discussed.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Humans; Immunocompetence

1993
Treatment of varicella in the immunocompetent adult.
    Journal of medical virology, 1993, Volume: Suppl 1

    Varicella in the immunocompetent adult is an infrequent but potentially serious infection. Previous studies in immunocompetent hosts and normal adults have demonstrated the value of intravenous acyclovir in the treatment of varicella-zoster virus infections. Oral acyclovir has also shown efficacy in both normal adults with zoster (shingles) and immunocompetent children with varicella. A recently completed double-blind placebo-controlled study of oral acyclovir in immunocompetent adults with uncomplicated varicella also demonstrated efficacy. Therapy within the first day reduced the time to 100% crusting of skin lesions from 7.4 to 5.6 days, and reduced the duration of fever by one-half day. Symptoms were also diminished. These benefits were observed only when therapy was initiated within 24 hours of the appearance of the rash. Adults with complicated varicella (usually symptomatic varicella pneumonia) should receive intravenous acyclovir. Several new agents for varicella-zoster therapy are being evaluated; brovavir is a new agent currently being compared to placebo in the treatment of adult varicella.

    Topics: Acyclovir; Adult; Chickenpox; Humans; Immunocompetence; Pneumonia, Viral

1993
Varicella zoster infections in bone marrow transplants.
    Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer, 1993, Volume: 132

    Topics: Acyclovir; Bone Marrow Transplantation; Chickenpox; Herpes Zoster; Humans; Vidarabine

1993
[Varicella: how and when to start antiviral treatment].
    Minerva pediatrica, 1993, Volume: 45, Issue:3

    The Meeting "An Update on Chickenpox" (Florence, 19-3-1993) has contributed to verify, in the light of the most recent acquisitions, the new guidelines for a correct rationale in the diagnosis and therapy of chickenpox. The present availability of an effective specific antiviral therapy for chickenpox (acyclovir) leads to a careful selection of patients to be treated. The high incidence of chickenpox morbidity keeps long unaltered and, beyond the usually benign onset of the primary infection in the child, the severity of this pathology in particular subjects and situations at risk is to be certainly underlined. Treatment is suggested for cases of chickenpox contracted inside the family. Generally, boys are at higher risk. Adolescents and adults, usually with a lower incidence, report a much higher severity of the acute onset and complications. Another category to be certainly treated is the one--in constant increase--of immunocompromised subjects. In any case, acyclovir treatment improves the symptomatologic evolution (pruritus and fever) and duration of clinical course. Among the progenitors of acyclovir, Valacyclovir seems to have the best prospects of success for the immediate future of antiviral therapy.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Female; Humans; Immunocompromised Host; Incidence; Male; Risk Factors

1993
Varicella in a susceptible pregnant woman.
    Current clinical topics in infectious diseases, 1993, Volume: 13

    Topics: Acyclovir; Chickenpox; Chickenpox Vaccine; Female; Herpesvirus 3, Human; Humans; Immunoglobulins; Infant, Newborn; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications, Infectious; Viral Vaccines

1993
Acyclovir: a decade later.
    The New England journal of medicine, 1992, Sep-10, Volume: 327, Issue:11

    Topics: Acyclovir; Chickenpox; Herpes Simplex; Herpes Zoster; Humans

1992
Therapeutic approaches to varicella-zoster virus infections.
    The Journal of infectious diseases, 1992, Volume: 166 Suppl 1

    Varicella-zoster virus (VZV) infections, the cause of chickenpox and shingles, are usually benign but are associated with morbidity and mortality, especially in immunocompromised hosts. Significant advances have been achieved in the treatment of VZV infections. In immunocompromised patients, both vidarabine and acyclovir have proved useful for the therapy of chickenpox and herpes zoster. Acyclovir, administered intravenously, is the treatment of choice for these infections. Both chickenpox and herpes zoster in the normal host are amenable to therapy with orally administered acyclovir. For older individuals with herpes zoster, acceleration of cutaneous healing can be accomplished at dosages of 800 mg five times a day for 10 days. Acyclovir therapy of chickenpox is recommended for adolescents and young adults with infection. In the future, improved therapies for VZV infections may include such newer antiviral drugs as bromovinyl arabinosyl uracil and acyclovir prodrugs.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Herpes Zoster; Humans; Immunocompromised Host; Interferons; Vidarabine

1992
Antiviral agents: problems and promises.
    The Medical journal of Australia, 1992, Jul-20, Volume: 157, Issue:2

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Drug Resistance, Microbial; Herpes Simplex; Herpes Zoster; Humans; Interferons

1992
[Varicella and pregnancy].
    Annales de dermatologie et de venereologie, 1992, Volume: 119, Issue:6-7

    Topics: Acyclovir; Chickenpox; Decision Trees; Female; Humans; Immunization, Passive; Infant, Newborn; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications, Infectious; Serologic Tests

1992
[Varicella pneumonia in adults].
    Orvosi hetilap, 1992, Dec-06, Volume: 133, Issue:49

    The authors treated 93 adult patients (83 male, 10 female) with varicella from 1st June 1987 to 30th April 1991. 13 patients had varicella pneumonia, two patients died. Special attention has been focused upon the diagnostic and prognostic problems, including bacterial superinfection. Authors stress the importance of the early diagnosis and treatment and discuss in detail the recent therapeutical and prophylactic opportunities.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Male; Pneumonia

1992
[Prevention of fetal and neonatal transmission of the varicella-zoster virus].
    Pathologie-biologie, 1992, Volume: 40, Issue:7

    Varicella occurs in 0.7 to 0.13% of pregnant women. The risk of transmission of the varicella-zoster virus to the fetus is small. The virus causes malformations (cutaneous scars and above all central nervous system anomalies). Mother-to-offspring transmission is more common during the perinatal period (20%), when mild or severe (fatal in 20% of cases) congenital varicella may occur. Prevention of transmission of the varicella-zoster virus from the mother to her fetus or neonate rests on detection of fetal varicella (antenatal ultrasonography, fetal IgM assays) and on administration of both specific anti-VZ virus immune globulins and acyclovir to the mother and neonate during the perinatal period.

    Topics: Acyclovir; Chickenpox; Female; Humans; Immunization, Passive; Infant, Newborn; Maternal-Fetal Exchange; Pregnancy; Vidarabine

1992
Varicella pneumonia in adults. A review of pulmonary manifestations, risk factors and treatment.
    Respiration; international review of thoracic diseases, 1992, Volume: 59, Issue:6

    Pneumonia is a rare but serious and occasionally fatal complication of varicella. Two cases of varicella pneumonia were successfully treated with acyclovir in our department. We reviewed the pulmonary manifestations of varicella, the risk factors and the effect of acyclovir on varicella pneumonia on immunocompetent adults. Early, aggressive therapy with acyclovir seems to abort the catastrophic consequences of varicella pneumonia, while oral acyclovir chemoprophylaxis is probably beneficial in high-risk populations with chickenpox.

    Topics: Acyclovir; Adult; Chickenpox; Drug Therapy, Combination; Humans; Male; Middle Aged; Pneumonia, Viral; Risk Factors

1992
[Varicella in pregnancy after the 20th week of amenorrhea].
    Journal de gynecologie, obstetrique et biologie de la reproduction, 1992, Volume: 21, Issue:8

    We report five cases of varicella pneumonia among ten otherwise healthy pregnant women who were admitted in our hospital between 1986 and 1991 with chickenpox. The precise frequency of this rare complication is not well known actually but analysis of the literature shows that the mortality rate is about 20%. Beside the problem of the fetal varicella syndrome, the other complication is the severe varicella of the neonate which can appear when varicella occurs in the mother within 5 days before, and 2 days after delivery. When primary varicella infection occurs during pregnancy clinical examination must be repeated for a week after occurring of the exanthema to find elements of severity significance. Acyclovir is the drug of choice (10 to 15 mg/kg every 8 hours) for 7 days when pneumonia is present. Varicella-zoster immunoglobulin is useful for prophylaxis and for neonates with high risk of severe varicella.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Female; Humans; Maternal Mortality; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Pregnancy Trimester, Second

1992
[Antiviral drug therapy of infections caused by Herpes simplex and Varicella Zoster viruses].
    Schweizerische medizinische Wochenschrift, 1992, Apr-18, Volume: 122, Issue:16

    Herpes simplex virus type 1 and 2 may cause painful mucocutaneous lesions in both immunosuppressed and immunocompetent patients. Indications for the use of acyclovir (ACV) are reviewed. In the second part the management of infections caused by varicella-zoster virus are discussed. Primary varicella (chickenpox) in immunosuppressed children should be treated with i.v. ACV without delay. In healthy patients varicella pneumonia needs to be treated with ACV. Healthy patients with herpes zoster are not usually candidates for antiviral therapy. The only exception is herpes zoster ophthalmicus. In patients with severe immunosuppression, such as transplant recipients, ACV therapy is recommended in order to reduce the rate of dissemination. First reports and our own observations on the development of ACV-resistant HSV and VZV isolates stress the importance of discriminating use of ACV and other antiviral compounds in immunosuppressed patients.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Herpes Simplex; Herpes Zoster; Herpes Zoster Ophthalmicus; Humans; Immunocompetence; Immunocompromised Host

1992
Varicella in pregnancy, the fetus, and the newborn: problems in management.
    The Journal of infectious diseases, 1992, Volume: 166 Suppl 1

    As many as 9000 pregnancies annually may be complicated by varicella, which creates management problems for the woman and her fetus or newborn. Estimates on risk to the fetus and to neonates vary widely, making counseling difficult. Likewise, the efficacy of passive immunization of pregnant women or their exposed newborns is not precisely known. In addition to these problems in clinical management, questions remain about the developmental immunology of varicella-zoster virus infection. For example, why do infants exposed in utero to the virus get zoster at an early age and why does passive immunization of newborns appear to be less effective than immunization of older individuals?

    Topics: Acyclovir; Chickenpox; Congenital Abnormalities; Female; Fetal Diseases; Herpes Zoster; Humans; Immunization, Passive; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious

1992
[Results of virostatic treatment of varicella with various severity].
    Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 1991, Volume: 42, Issue:2

    Chickenpox is the result of primary infection with the varicella zoster virus (VZV), which--like other herpes-viruses--has the ability to remain latent within the nervous system; reactivation then sometimes causes shingles many decades later. While chickenpox is benign in normal children, infection in the immunocompromised patient is characterized by a period of prolonged viral replication, delayed healing and a high frequency of extracutaneous manifestations, such as pneumonitis and involvement of the nervous system. Therefore, current therapeutic research efforts have focused on both the prevention of VZV infections through the development of a live, attenuated vaccine and improved therapeutic modalities. The existing antiviral drug acyclovir has been shown to be effective in reducing severe complications in risk groups. It has been generally accepted that the varicella vaccine is useful in immunocompromised children with acute leukaemia or solid malignant tumours. Healthy seronegative siblings will also benefit from the varicella vaccine. In addition, zoster hyperimmunoglobulin has also been shown to provide protection against primary VCV infection in the incubation period. Preventive and therapeutic efforts should mean that varicella will soon no larger be a medical problem even for immunocompromised patients.

    Topics: Acyclovir; Chickenpox; Herpesvirus 3, Human; Humans; Opportunistic Infections; Risk Factors

1991
Varicella-zoster virus infections in the immunocompromised host. Natural history and treatment.
    Scandinavian journal of infectious diseases. Supplementum, 1991, Volume: 80

    Varicella-zoster virus (VZV) causes significant morbidity and even mortality in immunocompromised patients. Varicella has more serious consequences than herpes zoster, although zoster is more common. This paper reviews the natural history of varicella-zoster infections, as well as strategies for prevention and treatment. Although initial studies supported the use of either vidarabine or acyclovir for treatment of varicella in immunocompromised children, subsequent data have shown acyclovir to be superior for this purpose. Recent data in bone marrow transplant patients indicated that acyclovir was also more effective in preventing progression of herpes zoster in the immunocompromised host. The question of using steroids to prevent postherpetic neuralgia remains controversial. With the advent of effective antiviral chemotherapy, treatment of VZV infections in the immunocompromised host has become a reality. The potential problem of acyclovir-resistant VZV strains justifies continued development of other anti-VZV agents. Several new compounds are presently in or slated for clinical trials.

    Topics: Acyclovir; Chickenpox; Chickenpox Vaccine; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunization, Passive; Immunocompromised Host; Vidarabine; Viral Vaccines

1991
Natural history and treatment of varicella-zoster in high-risk populations.
    The Journal of hospital infection, 1991, Volume: 18 Suppl A

    Rigorous clinical trials have established that both acyclovir and vidarabine favourably alter the clinical course of herpes zoster and chicken-pox in immunocompromised patients. In one comparative study, acyclovir was shown to be superior to vidarabine for zoster in bone marrow transplant recipients. These data, plus the fact that acyclovir is easier to administer than vidarabine, and perhaps less toxic, have made intravenous acyclovir the recognized drug of choice for treatment of herpes zoster in immunocompromised patients. Acyclovir sodium sterile powder received Federal Drug Administration (FDA) approval for this indication in 1990 in the United States. Since complications of zoster occur in only a minority of immunocompromised patients, most physicians would prefer to initiate therapy with an orally-administered drug and avoid the cost and inconvenience of hospitalization. Future studies will compare the efficacy and safety of orally administered bromovinyl arabinosyl uracil and acyclovir in treatment of varicella-zoster virus infections.

    Topics: Acyclovir; Administration, Oral; Adult; Aged; Chickenpox; Child; Clinical Trials as Topic; Herpes Zoster; Humans; Immunologic Deficiency Syndromes; Infusions, Intravenous; Vidarabine

1991
Oral acyclovir therapy for varicella and zoster infections in pediatric and pregnant patients: a brief review.
    Pediatric dermatology, 1991, Volume: 8, Issue:3

    Oral acyclovir recently was approved for the treatment of herpes zoster and has been shown to be effective in the treatment of varicella. Studies of the use of high-dose oral acyclovir in the management of varicella-zoster infections in immunocompetent pediatric patients are reviewed. Guidelines are provided for the drug's use in immunocompetent children and adolescents, pregnant patients, and pediatric atopic patients receiving systemic steroids.

    Topics: Acyclovir; Administration, Oral; Adolescent; Adrenal Cortex Hormones; Adult; Chickenpox; Child; Child, Preschool; Drug Administration Schedule; Female; Herpes Zoster; Humans; Male; Middle Aged; Pregnancy; Pregnancy Complications, Infectious

1991
Acyclovir for treatment of varicella in immunecompetent patients.
    Scandinavian journal of infectious diseases. Supplementum, 1991, Volume: 80

    Varicella, one of the most common childhood diseases, can cause significant morbidity and even mortality in immunecompetent persons. In the U.S. alone, an estimated 4000-6000 otherwise normal youngsters are hospitalized every year with an annual death rate for immunecompetent persons of 96. This article reviews and updates progress in clinical trials utilizing oral acyclovir for treatment of varicella in immunecompetent patients. Three placebo-controlled, double-blind studies of acyclovir in normal youngsters and adolescents found that the drug reduced the height and duration of fever and accelerated cutaneous healing without producing any adverse effects. Acyclovir did not diminish VZV antibody titers measured one year post-varicella by either ELISA or FAMA methods. A recent study in 148 immunecompetent adults demonstrated that acyclovir can significantly reduce fever and hasten cutaneous healing. Acyclovir is thus of proven benefit for treatment of varicella. The major issue remaining is who should be treated, and the pros and cons of this are discussed.

    Topics: Acyclovir; Chickenpox; Humans; Immunocompetence

1991
Use of acyclovir for varicella pneumonia during pregnancy.
    Obstetrics and gynecology, 1991, Volume: 78, Issue:6

    Twenty-one cases (five new and 16 literature) of varicella pneumonia of pregnancy were retrospectively reviewed to evaluate the benefits and risks of intravenous acyclovir on maternal and fetal outcomes. All women were in their second (12 cases) or third (nine cases) trimester. Mean gestational ages at the onset of pneumonia and time of delivery were 27 and 36 weeks, respectively. Twelve patients required mechanical ventilation. The mean duration of treatment was 7 days. No definite adverse drug effects were noted. Three women (14%) died of uncontrolled infection or complications. Two infants died (whose mothers also died): One was stillborn at 34 weeks' gestation, and the other died from prematurity shortly after birth at 26 weeks. No child was born with features of congenital varicella syndrome, and none developed active perinatal varicella infection. Onset of pneumonia during the third trimester was a risk factor associated with fatal maternal outcome. Intravenous acyclovir may reduce maternal morbidity and mortality associated with varicella pneumonia occurring during pregnancy, and appears to be safe for the developing fetus when given during the latter trimesters.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Drug Administration Schedule; Female; Humans; Injections, Intravenous; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Retrospective Studies

1991
Treatment with acyclovir of varicella pneumonia in pregnancy.
    Chest, 1991, Volume: 99, Issue:4

    Varicella pneumonia during pregnancy carries a significant mortality for both mother and fetus. The antiviral drug, acyclovir, appears to have decreased mortality in reported cases. We present a case report and review of the literature summarizing the experience to date with acyclovir in the treatment of varicella pneumonia during pregnancy.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious

1991
[Herpesvirus infections--indications for chemotherapy in dermato-venereology].
    Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 1990, Volume: 41, Issue:11

    Specific antivirals like acyclovir have ameliorated the outcome of severe herpesvirus infections, especially in immunocompromised patients. Varicella can be prevented in high-risk patients after exposure by therapy with varicella-zoster immunoglobulin. Despite this favorable development, there are many unresolved problems in the management of herpesvirus infections, such as the use of acyclovir during pregnancy, the treatment of both motoric neuropathy and postherpetic neuralgia. Chemotherapy-resistant herpesvirus may cause severe syndromes in patients suffering from HIV infection or from iatrogenic immunosuppression. Isolation of resistant viruses provides the stimulus to establish tests of viral resistance and to use antiviral drugs more carefully.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Drug Resistance; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Idoxuridine; Immunologic Deficiency Syndromes; Interferons; Vidarabine

1990
Acyclovir: the past ten years.
    Advances in experimental medicine and biology, 1990, Volume: 278

    Topics: Acyclovir; Chickenpox; Clinical Trials as Topic; Cytomegalovirus Infections; Drug Resistance, Microbial; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans

1990
[Infantile exanthematous virosis in adults].
    Medicina clinica, 1990, Apr-14, Volume: 94, Issue:14

    Topics: Acyclovir; Adult; Chickenpox; Child; Exanthema; Humans; Immunologic Deficiency Syndromes; Measles

1990
Consensus: varicella-zoster infections in pregnancy and the perinatal period.
    The Pediatric infectious disease journal, 1990, Volume: 9, Issue:12

    Topics: Acyclovir; Chickenpox; Female; Fetal Diseases; Herpes Zoster; Humans; Immunity, Maternally-Acquired; Immunization, Passive; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious

1990
Questions and controversies about varicella-zoster infections.
    Hospital practice (Office ed.), 1989, Mar-30, Volume: 24, Issue:3A

    Topics: Acyclovir; Adolescent; Adult; Age Factors; Chickenpox; Child; Child, Preschool; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immune Sera; Immunization, Passive; Infant; Pregnancy; Pregnancy Complications, Infectious; Recurrence; Time Factors; Vaccines, Attenuated

1989
Varicella-zoster virus infections: chronic disease in the immunocompromised host: evidence for persistent excretion of virus.
    The Pediatric infectious disease journal, 1989, Volume: 8, Issue:9

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Antiviral Agents; Chickenpox; Child; Chronic Disease; Herpes Zoster; Herpesvirus 3, Human; Humans; Immune Tolerance; Neoplasms; Pneumonia, Viral

1989
Acyclovir therapy during pregnancy.
    Obstetrics and gynecology, 1989, Volume: 73, Issue:3 Pt 2

    Although there are as yet no established indications for acyclovir use in pregnancy, the most reasonable uses are for maternal infections such as disseminated herpes simplex, varicella pneumonia, and severe primary genital herpes. Other potential, but more problematic, uses during pregnancy are for uncomplicated primary genital herpes infections, maternal varicella, and for prophylaxis against the recurrence of genital herpes near term. We review each of these potential uses and the pharmacokinetics of acyclovir in pregnancy while emphasizing that at the present time, safety, efficacy, and appropriate dosage of the drug have not been established for any use in pregnancy.

    Topics: Acyclovir; Chickenpox; Female; Herpes Genitalis; Humans; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious

1989
Varicella in pregnancy.
    The Journal of family practice, 1989, Volume: 28, Issue:3

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Immunization, Passive; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Infectious; Puerperal Disorders

1989
Varicella zoster virus infections in immunocompromised hosts. A review of the natural history and management.
    The American journal of medicine, 1988, Aug-29, Volume: 85, Issue:2A

    Varicella is relatively mild in otherwise normal children, in whom new lesions form for a mean of four days after onset and heal 50 percent of their lesions in eight days. New lesions form in most immunocompromised children for longer than five days and those not treated with antiviral drugs have a 28 percent incidence of pneumonitis and a 7 percent mortality rate. Untreated immunocompromised adults with herpes zoster shed virus for longer (7.0 days) than otherwise normal adults (5.3 days). Herpes zoster is much more likely to disseminate cutaneously in immunocompromised than in immunocompetent hosts. Visceral dissemination, which is a rare event in immunocompetent patients, occurred in 8 percent of prospectively followed untreated immunocompromised hosts with herpes zoster. Acyclovir has been found to be superior to vidarabine for treatment of both chickenpox and herpes zoster. Whether or not steroids should be used to treat herpes zoster remains controversial. Concerns about the use of intravenous acyclovir include the side effects of renal and central nervous system dysfunction and the possibility of emergence of resistant viral strains. None of these concerns has proved to be an impediment to successful treatment of immunocompromised patients. The major future challenge is to find an optimal way to treat varicella zoster virus infections with oral formulations of acyclovir or its congeners.

    Topics: Acyclovir; Chickenpox; England; Herpes Zoster; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Immune Tolerance; Vidarabine

1988
Management of varicella zoster infections in immunocompetent hosts.
    The American journal of medicine, 1988, Aug-29, Volume: 85, Issue:2A

    Varicella in otherwise healthy children usually requires no antiviral treatment. In severe cases, however, such as are seen in neonates and adults, treatment must be given. Anecdotal evidence suggests the efficacy of intravenous acyclovir in such patients. Herpes zoster in immunocompetent patients may be severe enough to warrant antiviral therapy, particularly in elderly patients. Both idoxuridine and acyclovir have been investigated in placebo-controlled double-blind studies. Due to its low toxicity, ease of administration, and the possibility of systemic administration, acyclovir has largely replaced older antivirals in the management of herpes zoster in the normal host. Recent studies have shown the efficacy of oral acyclovir. In addition, oral acyclovir may prevent the ocular complications of ophthalmic zoster. When acyclovir is given, it should be administered as early as possible, preferably no later than four days after the onset of the rash. The combination of acyclovir and prednisolone for the prevention of post-herpetic neuralgia has not proved effective.

    Topics: Acyclovir; Chickenpox; Clinical Trials as Topic; Herpes Zoster; Humans; Idoxuridine; Immunity; Neuralgia; Prednisolone

1988
Oral therapy with acyclovir in infants and children.
    The Pediatric infectious disease journal, 1987, Volume: 6, Issue:1

    Topics: Acyclovir; Administration, Oral; Chickenpox; Child; Child, Preschool; Drug Resistance, Microbial; Herpes Simplex; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Injections, Intravenous; Simplexvirus

1987
Drugs five years later: acyclovir.
    Annals of internal medicine, 1987, Volume: 107, Issue:6

    In the 5 years since its release for clinical use, acyclovir (9-[2-hydroxyethoxymethyl]guanine) has proved to be a safe and effective agent for therapy of herpes simplex and varicella-zoster infections. The drug's availability in topical, oral, and intravenous preparations has allowed its use in a range of clinical situations. Acyclovir must be phosphorylated by viral thymidine kinase in infected cells, where it then acts to inhibit viral DNA replication specifically. Epstein-Barr virus and human cytomegalovirus infections do not seem to respond to acyclovir therapy, although in-vitro effects on these viruses may be seen. Acyclovir is well absorbed and distributed, with cerebrospinal fluid levels 50% that of plasma. Clearance is almost entirely by the renal route, with a half-life of 20 hours in the anuric patient. Acyclovir has an excellent safety profile, its major adverse effect being transient serum creatinine elevations during high-dose intravenous use. Major uses include treatment of primary and recurrent genital herpes and herpes encephalitis and prophyllaxis and therapy of mucocutaneous herpes and varicella-zoster infections in immunocompromised patients. Resistance to acyclovir in herpes simplex virus is rarely encountered and does not seem to be due to long-term chronic suppressive therapy.

    Topics: Acyclovir; Chickenpox; Drug Interactions; Drug Resistance, Microbial; Ganciclovir; Herpes Simplex; Herpes Zoster; Herpesviridae; Humans; Postoperative Complications; Transplantation

1987
Treatment of varicella-zoster virus infections.
    Clinics in laboratory medicine, 1987, Volume: 7, Issue:4

    Effective antiviral therapy is now available for many forms of infection due to varicella-zoster virus. Acyclovir is the most widely prescribed treatment, but the virus is not exquisitely sensitive to this drug, and others are under study. The goals of therapy differ among different kinds of patients and must be considered when designing a treatment program.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Herpes Zoster; Humans; Immunocompetence; Neuralgia

1987
Skin infections.
    British medical bulletin, 1985, Volume: 41, Issue:4

    Topics: Acyclovir; Chickenpox; Herpes Genitalis; Herpes Labialis; Herpes Simplex; Herpes Zoster; Humans; Infant, Newborn; Interferons; Papillomaviridae; Skin Diseases, Infectious; Tumor Virus Infections

1985
[Prevention and therapy of herpesvirus infections].
    Zentralblatt fur Bakteriologie, Mikrobiologie und Hygiene. 1. Abt. Originale B, Hygiene, 1985, Volume: 180, Issue:2-3

    The group of the human-pathogenic herpesviruses comprises five subgroups: Herpes simplex virus type 1 (HSV-1), Herpes simplex virus type 2 (HSV-2), varicella zoster virus (VZV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). Primary infection with these ubiquitous herpesviruses usually occurs in childhood or during adolescence and frequently remains inapparent. However, it can also give rise to a variety of clinical pictures. Important clinical manifestations of herpesvirus infections are mucocutaneous lesions (HSV-1, HSV-2, VZV) self-limited, lymphoproliferative diseases (CMV, EBV) and congenital malformations (CMV). Primary infection with herpesviruses leads to a persistent infection of the host. This clinically silent condition of latency can be interrupted and may cause pathological symptoms to recur by reactivation of latent herpesviruses. A classical example of the clinical manifestation of herpesvirus reactivation is herpes zoster following an overcome varicella disease. The mechanism of herpesvirus reactivation has not yet been fully clarified. Reactivation of herpesviruses might be attributable to a weakening of the cellular immunodefence. For the control of viral infections mainly two cellular effector systems are responsible: unspecific, cytotoxic, natural killer (NK) cells and specific cytotoxic thymus-dependent (T) lymphocytes. The functional impairment of these cytotoxic active cells my cause herpesvirus reactivation in immunodeficient or immunosuppressed persons. Interference with the immunological control function may also contribute to the genesis of herpesvirus-associated tumours. Such an association between herpesviruses and human tumours is assumed to exist especially in the case of EBV. The frequently life-endangering severity of local or disseminated herpesvirus infections calls for suitable measures ensuring efficient prophylaxis and therapy. However, the possibilities of a specific immunoprophylaxis (vaccine, special immunoglobulins) against herpesvirus infections are still rather limited. The development of antiviral substances has greatly benefited from the introduction of new agents (Acyclovir) and the production of sufficient quantities of interferon (IFN) preparations during the last few years. Impressive results were obtained with the nucleoside-related substance Acyclovir in the prevention and therapy of primary or reactivated HSV-1 or HSV-2 infections. The use of Acyclovir as prophylactic agent produced the effect tha

    Topics: Acyclovir; Antiviral Agents; Burkitt Lymphoma; Chickenpox; Cytomegalovirus; Cytomegalovirus Infections; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Herpesviridae; Herpesviridae Infections; Herpesvirus 3, Human; Herpesvirus 4, Human; Humans; Immunity, Cellular; Immunization, Passive; Infectious Mononucleosis; Male; Nasopharyngeal Neoplasms; Simplexvirus; Smallpox Vaccine; T-Lymphocytes; Vidarabine

1985
Therapy for human herpesvirus infections. A perspective.
    The Alabama journal of medical sciences, 1985, Volume: 22, Issue:2

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Clinical Trials as Topic; Encephalitis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Idoxuridine; Infant, Newborn; Infant, Newborn, Diseases; Keratitis, Dendritic; Trifluridine; Vidarabine

1985
Treatment and prevention of virus infections in immunosuppressed patients.
    Antiviral research, 1985, Volume: Suppl 1

    Topics: Acyclovir; Chickenpox; Clinical Trials as Topic; Cytomegalovirus Infections; Double-Blind Method; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Immune Tolerance; Interferon Type I; Recurrence; Vidarabine

1985
Prevention of infectious complications in acute lymphoblastic leukemia.
    Seminars in oncology, 1985, Volume: 12, Issue:2

    Topics: Acute Disease; Acyclovir; Anti-Bacterial Agents; Bacterial Infections; Catheterization; Chickenpox; Gram-Negative Bacteria; Herpes Zoster; Humans; Immunization; Immunization, Passive; Infection Control; Leukemia, Lymphoid; Mycoses; Protozoan Infections; Sulfamethoxazole; Trimethoprim

1985
Treatment of human herpesvirus infections with special reference to encephalitis.
    The Journal of antimicrobial chemotherapy, 1984, Volume: 14 Suppl A

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Clinical Trials as Topic; Encephalitis; Female; Herpes Genitalis; Herpes Labialis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Idoxuridine; Infant, Newborn; Keratitis, Dendritic; Keratoconjunctivitis; Male; Vidarabine

1984
Advances in antiviral therapy: acyclovir.
    Pediatric dermatology, 1984, Volume: 2, Issue:1

    Acyclovir [9-(2-hydroxyethoxymethyl)guanine] is a newly licensed acyclic nucleoside analog that is active in vitro and in vivo against herpes simplex virus (HSV) and varicella zoster virus (VZV). This agent is available in the United States in topical and intravenous forms, and the oral preparation is currently being evaluated in clinical trials. The precise therapeutic role for acyclovir in patients with herpesvirus infections is still evolving. This article reviews the current status of this exciting new antiviral agent.

    Topics: Acyclovir; Aged; Chickenpox; Cytomegalovirus Infections; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Humans; Infant, Newborn; Infectious Mononucleosis; Injections, Intravenous; Keratitis, Dendritic; Male; Pregnancy; Risk; Virus Diseases

1984
Antiviral therapy. Varicella-zoster virus infections, herpes labialis and mucocutaneous herpes, and cytomegalovirus infections.
    Lancet (London, England), 1984, Sep-22, Volume: 2, Issue:8404

    Topics: Acyclovir; Administration, Oral; Administration, Topical; Antiviral Agents; Chickenpox; Cytomegalovirus Infections; Herpes Labialis; Herpes Simplex; Herpes Zoster; Humans; Immune Tolerance; Immunization; Injections, Intramuscular; Interferon Type I; Vidarabine

1984
Advances in antiviral therapy.
    The Journal of investigative dermatology, 1984, Volume: 83, Issue:1 Suppl

    Recent developments have increased the options for treatment of viral infections. Vidarabine, an agent originally released for herpes simplex encephalitis, has more recently been shown to be of benefit in neonatal herpes simplex infection and in varicella-zoster infections in immunocompromised hosts. The introduction of acyclovir represents a major advance in antiviral therapy because of its low host toxicity and marked selectivity for herpes simplex and varicella-zoster viruses. Extensive controlled clinical trials demonstrate efficacy in the treatment of infections caused by these viruses in the immunocompromised host and in genital herpes simplex infections in normal hosts. The use of recombinant DNA technology has increased the purity, variety, and availability of interferons for clinical trial. Earlier experience with natural buffy coat-derived alpha interferon showed efficacy in the treatment of varicella-zoster infections in the immunocompromised host, as well as prophylaxis of herpes virus infections in high-risk populations. These results have to be confirmed using the newer interferon preparations. Under development are a variety of new drugs with broadened viral spectrum and improved pharmacokinetic properties. These include nucleoside analogues and novel interferons with modified amino acid sequences. One or more of these agents, used singly or in combination, may prove useful in the more difficult therapeutic problems, such as cytomegalovirus and hepatitis B infections.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Infant, Newborn; Interferons; Male; Respiratory Tract Infections; Vidarabine

1984
Acyclovir and other chemotherapy for herpes group viral infections.
    Annual review of medicine, 1984, Volume: 35

    The recent profusion of antiviral research has resulted in significant advances toward prevention and treatment of herpes group virus infections. The most promising new agent is acyclovir, which is available in topical, intravenous, and oral formulations. Results of clinical trials of acyclovir for prevention and treatment of herpes simplex, varicella-zoster virus, cytomegalovirus, and Epstein-Barr virus infections are discussed, and the potential problem of antiviral resistance considered. Vidarabine therapy is reviewed briefly, and future new drugs with activity against herpesviruses are mentioned.

    Topics: Acyclovir; Chickenpox; Cytomegalovirus Infections; Drug Resistance, Microbial; Encephalitis; Female; Herpes Genitalis; Herpes Labialis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Keratitis, Dendritic; Male; Vidarabine

1984
Antiviral drugs today.
    The New Zealand medical journal, 1984, Dec-12, Volume: 97, Issue:769

    Topics: Acyclovir; Administration, Topical; Adolescent; Amantadine; Antiviral Agents; Chickenpox; Child; Clinical Trials as Topic; Encephalitis; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Humans; Idoxuridine; Influenza, Human; Keratitis, Dendritic; Male; Rimantadine; Vidarabine

1984
Drug therapy. Treatment of herpesvirus infections.
    The New England journal of medicine, 1983, Oct-20, Volume: 309, Issue:16

    Topics: Acyclovir; Antiviral Agents; Bromodeoxyuridine; Chickenpox; Herpes Zoster; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Immune Tolerance; Interferon Type I; Interferons; Vidarabine

1983
Varicella and herpes zoster. Changing concepts of the natural history, control, and importance of a not-so-benign virus.
    The New England journal of medicine, 1983, Dec-08, Volume: 309, Issue:23

    New knowledge of the relationship between the varicella-zoster virus and its host suggests a heretofore unappreciated dynamic pattern. Molecular finger-printing has demonstrated a degree of heterogeneity between different strains of virus. It is probable that exogenous reinfection with different strains and endogenous reactivation are commonplace events, although usually asymptomatic. The lability of the endogenous interaction inversely parallels the responsiveness of the cell-mediated immune system--a major factor in viral containment by the human host. Thus, the therapeutic use of immunosuppressive or cytotoxic substances increases the morbidity and mortality associated with varicella-zoster. Promising new approaches to the prevention and treatment of the virus should alter the balance in favor of the host.

    Topics: Acyclovir; Chickenpox; Cross Infection; Disease Outbreaks; Female; Herpes Zoster; Humans; Immune Tolerance; Immunization, Passive; Infant, Newborn; Interferons; Pregnancy; Reye Syndrome; Transfer Factor; Vaccination; Vaccines, Attenuated; Viral Vaccines

1983
Viral infections in immunocompromised patients.
    The Medical clinics of North America, 1983, Volume: 67, Issue:5

    Topics: Acyclovir; Adult; Antiviral Agents; Burkitt Lymphoma; Chickenpox; Child; Cytomegalovirus Infections; Disease Susceptibility; Enterovirus Infections; Herpes Simplex; Herpes Zoster; Humans; Immunologic Deficiency Syndromes; Immunosuppression Therapy; Infectious Mononucleosis; Orthomyxoviridae Infections; Respirovirus Infections; Vidarabine; Virus Diseases

1983
Acyclovir therapy of varicella-zoster virus infections in immunocompromised patients.
    The Journal of antimicrobial chemotherapy, 1983, Volume: 12 Suppl B

    In a randomized, placebo-controlled, double-blind trial of intravenous acyclovir in the treatment of varicella zoster virus (VZV) infections, 8 of 20 immunocompromised children with varicella received acyclovir (500 mg/m2/dose three times daily for 7 days). There was no significant difference in skin healing between the acyclovir and placebo groups although there was a significant reduction in the incidence of development of pulmonary involvement during acyclovir treatment. Nineteen out of 34 patients received vidarabine (10 mg/kg/day for 5 days). Vidarabine significantly shortened the duration of new vesicle formation. Both drugs significantly reduced the incidence of visceral varicella, the most serious complication of VZV infection. An open trial also concluded that early treatment of varicella in these patients is essential. Of the 94 patients with zoster infection, 52 received acyclovir (500 mg/m2/dose infused over one hour three times daily for 7 days). Acyclovir recipients healed more rapidly, had fewer days of pain and shorter duration of viral shedding compared with placebo patients. The most important finding was that acyclovir significantly protected against progression of zoster as defined by development or progression of cutaneous dissemination and development of visceral zoster. Vidarabine seemed to be equally effective in this respect. The likelihood of cutaneous dissemination is related to the nature of the underlying condition. The in vitro sensitivity of VZV isolates from patients with second episode VZV infection during the trial did not change appreciably which suggests that VZV does not become resistant to acyclovir during therapy.

    Topics: Acyclovir; Adolescent; Adult; Aged; Bone Marrow Transplantation; Chickenpox; Child; Clinical Trials as Topic; Double-Blind Method; Drug Resistance, Microbial; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunosuppression Therapy; Injections, Intravenous; Kidney Transplantation; Lymphoproliferative Disorders; Male; Middle Aged; Neoplasms; Random Allocation; Vidarabine

1983
The present and future for acyclovir.
    The Journal of antimicrobial chemotherapy, 1983, Volume: 12 Suppl B

    Topics: Acyclovir; Chickenpox; Cytomegalovirus Infections; Drug Resistance, Microbial; Female; Hepatitis B; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Infectious Mononucleosis; Male; Recurrence

1983
Acyclovir treatment of herpes simplex virus infections in immunocompromised humans. An overview.
    The American journal of medicine, 1982, Jul-20, Volume: 73, Issue:1A

    As reflected in the preclinical and early clinical data, acyclovir seems destined to have a very useful role in the treatment and/or prophylaxis of herpes virus (HSV) infections in immunosuppressed humans. If the preclinical predictions can be extrapolated to varicella-zoster (V-Z) infections, acyclovir could well also play a meaningful role in therapy of V-Z infections in the immunosuppressed host; however, this conjecture awaits proof of controlled studies in humans. Clearly the usefulness of acyclovir for treatment of V-Z infections should be compared with that of adenine arabinoside (ara-A) to put into proper perspective the relative efficacies of the two drugs for future therapeutic regimens. The need for comparative studies is most important at this early stage of antiviral drug development, to avoid ethical problems that will cloud the knowledge needed to move forward in a positive way. In any event, the development of acyclovir, with its targeted approach, represents a real fundamental advance in antiviral drug development. Together with the development and deployment of ara-A, it should provide the needed impetus for a surge in the creation of new antiviral compounds for tomorrow.

    Topics: Acyclovir; Administration, Topical; Antiviral Agents; Chickenpox; Cytomegalovirus Infections; Guanine; Hepatitis B; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Immune Tolerance; Infectious Mononucleosis; Infusions, Parenteral

1982

Trials

46 trial(s) available for acyclovir and Chickenpox

ArticleYear
Combining corticosteroids and acyclovir in the management of varicella pneumonia: a prospective study.
    Antiviral therapy, 2014, Volume: 19, Issue:2

    Studies found in the literature which describe the treatment of varicella pneumonia with a combination of acyclovir and corticosteroids tend to be retrospective in nature and limited with regard to the data supplied.. This prospective study was performed at King Abdul Aziz Specialist Hospital in Taif, Saudi Arabia. The study covered adult patients admitted with a diagnosis of varicella pneumonia over a period of 10 years (January 2003 to December 2012). All patients were treated uniformly according to the predefined protocol with acyclovir and corticosteroids. The clinical characteristics, laboratory investigations, hospital course, any complications and the treatment outcomes were studied.. A total of 32 patients (25 males, mean age 43.5 ±14.5 years) were enrolled into this study; 3 patients (2 patients aged <12 years, 1 patient with advanced cardiac failure) were excluded. Of these 32 patients, 18 (58%) were current smokers, 16 patients (50%) were admitted to the intensive care unit and of these, 14 (87.5%) required mechanical ventilation. The mean duration of intensive care unit stay was 5.59 ±5.37 days. All patients were treated with intravenous acyclovir, corticosteroids and antibiotics were added when indicated. 31 patients improved and were discharged home. There was one death (a 32 year-old female with underlying systemic lupus erythematosus).. Patients with varicella pneumonia are at high risk of respiratory failure. Early implementation of supportive therapy seems to positively influence the recovery rate and outcome. Our study supports treatment using a combination of acyclovir and corticosteroids.

    Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Aged; Aged, 80 and over; Chickenpox; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Pneumonia, Viral

2014
Pharmacokinetics and safety of famciclovir in children with herpes simplex or varicella-zoster virus infection.
    Antimicrobial agents and chemotherapy, 2009, Volume: 53, Issue:5

    Two multicenter, open-label, single-arm, two-phase studies evaluated single-dose pharmacokinetics and single- and multiple-dose safety of a pediatric oral famciclovir formulation (prodrug of penciclovir) in children aged 1 to 12 years with suspicion or evidence of herpes simplex virus (HSV) or varicella-zoster virus (VZV) infection. Pooled pharmacokinetic data were generated after single doses in 51 participants (approximately 12.5 mg/kg of body weight [BW] for children weighing < 40 kg and 500 mg for children weighing > or = 40 kg). The average systemic exposure to penciclovir was similar (6- to 12-year-olds) or slightly lower (1- to < 6-year-olds) than that in adults receiving a 500-mg dose of famciclovir (historical data). The apparent clearance of penciclovir increased with BW in a nonlinear manner, proportional to BW(0.696). An eight-step weight-based dosing regimen was developed to optimize exposure in smaller children and was used in the 7-day multiple-dose safety phases of both studies, which enrolled 100 patients with confirmed/suspected viral infections. Twenty-six of 47 (55.3%) HSV-infected patients who received famciclovir twice a day and 24 of 53 (45.3%) VZV-infected patients who received famciclovir three times a day experienced at least one adverse event. Most adverse events were gastrointestinal in nature. Exploratory analysis following 7-day famciclovir dosing regimen showed resolution of symptoms in most children with active HSV (19/21 [90.5%]) or VZV disease (49/53 [92.5%]). Famciclovir formulation (sprinkle capsules in OraSweet) was acceptable to participants/caregivers. In summary, we present a weight-adjusted dosing schedule for children that achieves systemic exposures similar to those for adults given the 500-mg dose.

    Topics: 2-Aminopurine; Acyclovir; Antiviral Agents; Chickenpox; Child; Child, Preschool; Drug Administration Schedule; Drug Therapy, Combination; Famciclovir; Female; Herpes Simplex; Herpesvirus 3, Human; Humans; Infant; Male; Simplexvirus; Treatment Outcome

2009
[Randomized controlled multi-center trial for treatment of varicella in pediatric patients with hydrochloride valacyclovir].
    Zhonghua er ke za zhi = Chinese journal of pediatrics, 2008, Volume: 46, Issue:6

    To evaluate the efficacy and safety of hydrochloride valacyclovir in treatment of varicella in pediatric patients between April 2006 and March 2007.. A randomized controlled multi-center clinical trial was conducted in 5 pediatric centers, i.e., Children's Hospital of Fudan University, Children's Hospital of Zhejiang University, Children's Hospital of Nanjing Medical University, Pediatric Department of Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology and Children's Hospital, Chongqing University of Medical Sciences. Patients who were clinically diagnosed as varicella without any complications and were beyond 3 years of age were enrolled into the study from the out-patient clinics. The subjects were divided into two groups randomly, one was treated with hydrochloride valacyclovir, the other with ribavirin. There were 128 cases in the group treated with hydrochloride valacyclovir and 132 cases in control group treated with ribavirin. The treatment duration of two groups was five days. The clinical efficacy and safety were evaluated after the first day and the fourth day of the treatment and within three days after the end of the treatment. The clinical efficacy was assessed by efficacy index.. (1) The efficacy index on the fourth day of the therapy (0.80 +/- 0.24) in the valacyclovir group was significantly higher than that of ribavirin control group (0.59 +/- 0.37) (t = 5.42, P < 0.01). The efficacy index at the end of the treatment (0.86 +/- 0.14) in the hydrochloride valacyclovir group was also significantly higher than that (0.70 +/- 0.30) of the ribavirin control group (t = 5.43, P < 0.01). (2) In the valacyclovir and ribavirin groups, the effective rates on the fourth day of the therapy were 94.53% and 72.7% respectively (chi2) = 22.38, P < 0.01). The effective rates at the end of the therapy were 99.2% and 88.6%, respectively (chi(2) = 12.60, P < 0.01). The rates of cure of the two groups were 33.6% and 25.0% (chi2) = 2.32, P > 0.05). (3) No severe adverse drug reactions were observed in any of the two groups.. The hydrochloride valacyclovir was safe, reliable and convenient in treatment of uncomplicated varicella in children.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Child, Preschool; Female; Humans; Male; Valacyclovir; Valine

2008
Prophylaxis of intravenous immunoglobulin and acyclovir in perinatal varicella.
    European journal of pediatrics, 2001, Volume: 160, Issue:2

    Maternal chickenpox around the time of delivery can cause severe and even fatal illness in the newborn but an effectively preventive method has not yet been established. We proposed that a combination of intravenous immunoglobulin (IVIG) and acyclovir (ACV) intravenously could effectively prevent perinatal varicella. A group of 24 newborn infants whose mother had developed a varicella rash within 14 days before and after delivery were studied. Some 15 infants whose mothers' rash appeared within 7 days before and 5 days after delivery were categorised as an at-risk group and received IVIG prophylaxis (500 mg/kg) administered soon after birth or post-natal contact either alone or with intravenous acyclovir (5 mg/kg every 8 h) for a total of 5 days starting from 7 days after the onset of maternal rash. Of four infants receiving IVIG alone, two developed clinical varicella. None of ten infants receiving both IVIG and ACV contracted varicella. One infant receiving ACV alone had no varicella vesicles either. Of nine infants in the not at-risk group four had undetectable varicella-zoster virus antibody on admission and developed clinical varicella subsequently.. The combination of intravenous immunoglobulin given soon after birth and prophylactic acyclovir intravenously administered 7 days after the onset of maternal rash can effectively prevent perinatal varicella.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Female; Humans; Immunoglobulins, Intravenous; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Infectious; Taiwan

2001
Controlled trial of acyclovir for chickenpox evaluating time of initiation and duration of therapy and viral resistance.
    The Pediatric infectious disease journal, 2001, Volume: 20, Issue:10

    Chickenpox is prevalent in the US despite the availability of an effective vaccine. Acyclovir treatment is limited by concerns about efficacy if given after the first day of rash and by concerns about induction of viral resistance.. Evaluate initiation and duration of acyclovir treatment of chickenpox and its effect on viral resistance.. Randomized, placebo-controlled, double blind trial in immunocompetent patients who were stratified by age at enrollment (children, 2 to 11 years; adolescents, > or = 12 to 18 years; adults, > or = 19 years) and duration of rash (< or = 24 h vs. >24 to 48 h). Lesions were staged, counted and cultured; temperatures and symptoms were recorded daily.. Subjects presenting within 24 h of rash onset (Group A) were randomly assigned to 5 or 7 days of oral acyclovir treatment, 80 mg/kg/day up to a maximum of 3,200 mg/day in four divided doses. Subjects whose rash was >24 to 48 h old were randomized to receive 5 days of acyclovir treatment beginning on the first (Group B1) or second study day (Group B2). Matching placebos were used to ensure that subjects uniformly received 28 doses of study compound.. Of the 177 subjects recruited Group A patients who were treated on the first day of rash had the greatest number of significantly shortened event times with 5 days of therapy being equivalent to 7 days. There also were some shorter times to events for Group B1 patients who began therapy on the second day of rash vs. Group B2 patients who started acyclovir on the third. These included: time to maximum lesion formation (adolescents, P = 0.007; children, P = 0.03); 50% healing in adolescents (P = 0.005); and residual facial lesions in adults (P = 0.047). The probability of viral shedding was significantly reduced for Group A subjects vs. Group B1 subjects (P = 0.006). Viruses shed during therapy remained susceptible to acyclovir and retained normal thymidine kinase function.. Immunocompetent children, adolescents and adults with chickenpox displayed a gradation in their clinical responses to acyclovir that correlated with the time from onset of rash to initiation of therapy. Five days of therapy is sufficient because a 7-day course provided no additional benefit. The susceptibility to acyclovir of viruses shed during treatment did not change; however, the effect of therapy on resistance of latent virus was not assessed.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Child; Child, Preschool; Double-Blind Method; Drug Administration Schedule; Drug Resistance, Viral; Female; Humans; Male; Middle Aged; Time Factors; Treatment Outcome

2001
Varicella zoster virus infections following allogeneic bone marrow transplantation: frequency, risk factors, and clinical outcome.
    Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2000, Volume: 6, Issue:1

    Reactivation of varicella zoster virus (VZV) is a common event in patients undergoing allogeneic bone marrow transplantation (BMT) and may lead to life-threatening complications. We retrospectively analyzed the incidence, clinical outcome, and risk factors for VZV infections occurring within the first 5 years of transplantation in 100 consecutive adults undergoing allogeneic BMT between 1992 and 1997. Forty-one patients (41%) developed VZV reactivation a median of 227 days (range 45-346 days) post-transplantation. Twelve percent of VZV reactivation occurred in the first 100 days and 88% within the first 24 months. Among those who survived for 2 or more years after transplantation (n = 47), 59% developed VZV infection. Forty percent of patients with VZV reactivation required admission with a mean hospital stay of 7.2 days. Two patients developed encephalitis, and 1 died despite antiviral therapy. The most frequent complications were post-herpetic neuralgia and peripheral neuropathy (68%). Thoracic dermatomal zoster represented 41% of the infections; disseminated cutaneous involvement was observed in 17% of patients. No clinical or epidemiologic risk factors were associated with recurrence. Administration of ganciclovir for prevention of cytomegalovirus infection delayed the onset of VZV infection beyond 4 months (P = .06). In a further subset analysis, patients with a limited chronic graft-versus-host disease (GVHD) had a lower estimated incidence of VZV reactivation compared with those with extensive chronic GVHD (P = .11). We conclude that complications from reactivation of VZV infection are common and associated with considerable morbidity and mortality in patients undergoing allogeneic BMT.

    Topics: 2-Aminopurine; Acyclovir; Adolescent; Adult; Antiviral Agents; Bone Marrow Transplantation; Chickenpox; Cytomegalovirus Infections; Famciclovir; Female; Graft vs Host Disease; Herpes Zoster; Herpesvirus 3, Human; Humans; Incidence; Male; Middle Aged; Pain; Retrospective Studies; Risk Factors; Skin Diseases; Transplantation, Homologous; Treatment Outcome; Virus Activation

2000
Varicella-zoster infection after allogeneic bone marrow transplantation: incidence, risk factors and prevention with low-dose aciclovir and ganciclovir.
    Bone marrow transplantation, 2000, Volume: 25, Issue:6

    We examined the incidence of herpes varicella-zoster virus (VZV) infection in 151 patients undergoing allogeneic BMT between August 1990 and September 1997 and who survived at least 3 months. Median follow-up was 17 (range 3.3-80.7) months. Herpes simplex virus antibody positive (HSV+) patients received aciclovir 1200 mg p.o. daily or 750 mg i.v. daily, in divided doses from day 0 to engraftment. Ganciclovir (5 mg/kg i.v. three times per week) was given in CMV+ patients (or if the donor was CMV+) from engraftment to day 84. Ganciclovir was continued or recommenced if a dose of greater than 20 mg of prednisone was used for the treatment of GVHD otherwise aciclovir was recommenced. In HSV+ patients not receiving ganciclovir, aciclovir 600 mg p.o. daily in divided doses was given until at least 6 months after BMT. Thirty-two patients developed VZV infection from 4.1 to 28 months after transplant. The estimated cumulative incidence of VZV was 13% (95% confidence interval 6-19%) at 12 months, 32% (22-42%) at 24 months and 38% (27-50%) at 28 months, with no further cases beyond that time. No patient developed VZV whilst receiving aciclovir or ganciclovir (P < 0.0001). However, there was a rapid onset of VZV following cessation of antiviral therapy (33% (20-46%) at 1 year post cessation). The presence of GVHD and the prior duration of antiviral prophylaxis were significant and independent risk factors for the development of VZV. Age, underlying disease, conditioning therapy or donor type were not. We conclude that 3-6 months of low-dose aciclovir and ganciclovir are effective at delaying the onset of VZV after allogeneic BMT, but may not affect the overall incidence of infection. Prolonged prophylaxis may be warranted in patients at high risk of infection, for example those patients with GVHD.

    Topics: 2-Aminopurine; Acyclovir; Adolescent; Adult; Age of Onset; Aged; Analysis of Variance; Antiviral Agents; Bone Marrow Transplantation; Chickenpox; Dose-Response Relationship, Drug; Enzyme Activation; Famciclovir; Female; Ganciclovir; Graft vs Host Disease; Herpes Zoster; Herpesvirus 3, Human; Humans; Incidence; Male; Middle Aged; Prodrugs; Retrospective Studies; Risk Factors; Skin Diseases; Transplantation, Homologous; Valacyclovir; Valine

2000
Acyclovir prophylaxis of varicella in children with renal disease receiving steroids.
    Pediatric nephrology (Berlin, Germany), 2000, Volume: 14, Issue:4

    Varicella, or chickenpox, is very communicable and has been shown to be transmitted to nearly 90% of household contacts. Severe varicella infections with fatal complications have been noted in children receiving corticosteroids despite the administration of varicella-zoster immune globulin (VZIG). The use of post-exposure acyclovir prophylaxis in immunocompetent children exposed to a household contact with varicella has been shown to decrease the transmission rate of varicella significantly. We studied the safety and efficacy of acyclovir prophylaxis as an adjunctive preventive measure in 8 children (10 separate exposures) receiving corticosteroids for renal disease. Four children (6 separate exposures) served as controls. No adverse reactions were reported with the acyclovir prophylaxis. The maximum change between pre- and study serum creatinine levels was 0.1 mg/dl. None of the 8 patients who received acyclovir prophylaxis developed chickenpox. One of these 8 patients developed humoral immunity to varicella despite the absence of clinical infection. One of 4 patients who received VZIG prophylaxis alone developed chickenpox. These data support the use of acyclovir prophylaxis as an adjunctive measure to VZIG for the prevention of potentially serious varicella infection in children receiving steroids.

    Topics: Acyclovir; Adolescent; Adrenal Cortex Hormones; Antiviral Agents; Chickenpox; Child; Child, Preschool; Female; Graft Rejection; Humans; Kidney Diseases; Kidney Transplantation; Male; Nephrotic Syndrome

2000
Sequential use of intravenous and oral acyclovir in the therapy of varicella in immunocompromised children.
    The Pediatric infectious disease journal, 1998, Volume: 17, Issue:7

    Immunocompromised children are at risk for disseminated varicella infections. Standard management involves hospitalization and intravenous acyclovir for 7 to 10 days. This approach is expensive, is inconvenient and may not be necessary. We undertook a pilot study to assess the safety and efficacy of an alternative approach that utilized a combination of intravenous (i.v.) followed by oral (p.o) acyclovir in a cohort of immunocompromised children.. The cohort consisted of 26 immunocompromised children between the ages of 1.5 and 12.7 years (mean, 6.3). Therapy was commenced with i.v. acyclovir (1500 mg/m2/day in 3 divided doses). Concurrent management included holding or reducing immunosuppressive therapy (by 50%) and administering varicella-zoster immunoglobulin in 69% (11 of 16) of cases where exposure to chickenpox was recognized. Patients were eligible to switch to p.o therapy after receiving a minimum of 48 h of i.v. acyclovir therapy provided they were afebrile; had no new lesions for 24 h; had no internal organ involvement and were able to tolerate oral medications. Patients were observed in hospital for a further 24 h and then discharged provided they remained well. Oral acyclovir was continued for a total of 7 to 10 days (i.v. plus p.o).. Of the 26 patients 25 were successfully switched from i.v. to p.o after 4.1 +/- 1.2 days (mean +/- SD) (range, 2.3 to 6) Children had fever for a mean of 2.0 +/- 1.6 days (range, 0 to 5) and developed new lesions for 2.9 +/- 0.7 days (range, 2 to 4). All 25 patients switched to p.o therapy had resolution of their disease and no patient required resumption of i.v. therapy.. The sequential use of i.v. followed by p.o acyclovir is feasible in the treatment of varicella in immunocompromised children and results in a reduction in duration of intravenous therapy and hospitalization.

    Topics: Acyclovir; Administration, Oral; Antiviral Agents; Area Under Curve; Chickenpox; Child; Child, Preschool; Cohort Studies; Female; Hospitalization; Humans; Immunocompromised Host; Infant; Injections, Intravenous; Linear Models; Male; Pilot Projects

1998
Incidence and natural history of chemically defined varicella-zoster virus hepatitis in children and adolescents.
    Scandinavian journal of infectious diseases, 1997, Volume: 29, Issue:1

    Of 786 children and adolescents enrolled in a multicenter trial of acyclovir for chickenpox, 27 (3.4%) met the case definition of varicella-zoster virus (VZV) hepatitis (serum aspartate aminotransferase level > or = 100 U/l). The clinical and cutaneous manifestations of chickenpox in the 15 placebo recipients with this complication did not differ significantly from those in 45 matched controls (p > 0.05), indicating that liver involvement by VZV is not a consequence of more extensive disease. Although acyclovir modified the course of chickenpox overall, it did not prevent VZV hepatitis; that is, the proportions of affected subjects with liver involvement postenrollment did not differ significantly between the drug and placebo recipients (50% vs 80%, p > 0.05). Serum aspartate aminotransferase levels that were elevated on day 4 postenrollment had returned to normal (< or = 60 U/l) by day 28 in 88% of the placebo group and in 83% of the drug-treated group. With 2 exceptions, all values were normal by 88 days postenrollment. We conclude that chemically defined VZV hepatitis is an infrequent, self-limiting complication of chickenpox in otherwise healthy children and adolescents.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Aspartate Aminotransferases; Case-Control Studies; Chi-Square Distribution; Chickenpox; Child; Child, Preschool; Double-Blind Method; Hepatitis, Viral, Human; Herpesvirus 3, Human; Humans; Incidence; Mississippi; Statistics, Nonparametric

1997
Potential benefit of acyclovir for chickenpox acquired from household contacts. The Italian Acyclovir-Chickenpox Study Group.
    Journal of chemotherapy (Florence, Italy), 1997, Volume: 9, Issue:3

    As a part of a trial of acyclovir treatment of chickenpox in otherwise healthy children, the assessment of disease features and evolution showed a significantly more severe clinical picture at onset in the 215 patients with intrafamiliar exposure to varicella, compared with the remaining 486 with community-acquired infection, although the disease course proved similar by the third day of antiviral therapy. Children with household exposure to varicella are likely to suffer from a more severe disease, and might especially benefit from acyclovir treatment.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Community-Acquired Infections; Female; Humans; Infant; Male

1997
Dose-dependent effects of oral acyclovir in the incubation period of varicella.
    Acta paediatrica (Oslo, Norway : 1992), 1996, Volume: 85, Issue:12

    Dose of acyclovir (ACV) and clinical features of varicella were evaluated in 65 household contacts (0.8-9 y) who received oral ACV (5-80 mg/kg daily in four divided doses) during the latter half of the incubation period of varicella. The severity of the disease was compared with that of 23 children who did not receive ACV. Infection was confirmed by a fluorescent antibody to membrane antigen assay. The antibody titers and the rate of apparent infection increased as the dose of ACV administered decreased. The number of skin lesions in patients who received ACV was significantly reduced when compared to the control group. These data suggest dose-dependence of ACV for modification of varicella during secondary viremia in the incubation of the disease.

    Topics: Acyclovir; Administration, Oral; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Dose-Response Relationship, Drug; Female; Humans; Infant; Male

1996
Varicella in immunocompetent children in the first two years of life: role of treatment with oral acyclovir. Italian Acyclovir-Chickenpox Study Group.
    Journal of chemotherapy (Florence, Italy), 1995, Volume: 7, Issue:1

    An open multicenter study has been carried out to evaluate efficacy and tolerability of oral acyclovir in the treatment of varicella in immunocompetent patients in the first two years of life. Fifty-three children aged 3-24 months received acyclovir at 80 mg/Kg/day in four divided doses for 4 to 6 days; 24 of them were treated in the first 24 hours following disease onset, while the remaining 29 patients were enrolled within 48 hours. The assessment of evolution of disease signs and symptoms showed a rapid resolution of fever, itching and other constitutional symptoms, with interruption of vesicle formation and acceleration of cutaneous healing processes. No statistically significant differences have been demonstrated as to disease progression between patients treated in the first 24 hours, when compared with subjects receiving acyclovir in the following 24 hours. Acyclovir confirmed its excellent clinical and laboratory safety profile. By acting favorably on both the duration and severity of disease signs and symptoms, acyclovir treatment should be recommended in young children and infants with varicella, since a higher incidence of severe and complicated disease has been observed in these patient groups.

    Topics: Acyclovir; Administration, Oral; Chickenpox; Child, Preschool; Female; Follow-Up Studies; Humans; Immunocompetence; Infant; Male; Suspensions; Treatment Outcome

1995
Oral acyclovir in the treatment of adult varicella.
    Annals of the Academy of Medicine, Singapore, 1995, Volume: 24, Issue:2

    An open study was conducted to evaluate the efficacy of oral acyclovir in a group of 295 Singapore Armed Forces male servicemen. The 148 patients who were willing to take acyclovir were given 800 mg orally five times per day for seven days. The other 147 who refused to take acyclovir were monitored as a control group. Each of these groups was further classified into two groups. Group A patients presented with rash within 24 hours of rash onset and Group B presented between 24 and 72 hours. Daily lesion counts, temperature, pruritus scores and laboratory tests were used to monitor disease progression. Early acyclovir intervention (Group A) reduced the time to 100% crusting from 7.19 to 5.71 days (P = 0.0001), decreased the maximum number of all lesions by 26% (P = 0.03) and the maximum number of vesicular lesions by 45% (P = 0.0004). Late therapy (Group B) was effective in reducing the maximum number of vesicular lesions by 38% (P = 0.003). The number of patients requiring antibiotics for suspected secondary skin infection, the duration of fever and paracetamol consumption were significantly reduced in both the early and late intervention groups. However, there were no effects in minimizing pruritus in either group. Serious complications such as pneumonia, encephalitis or death were not observed in this study. The most common adverse effect of acyclovir was mild diarrhoea occurring in 35% of patients treated with the drug. We conclude that early treatment with acyclovir was beneficial whereas late therapy had limited effect in reducing the severity of cutaneous lesions in patients with varicella.

    Topics: Acyclovir; Administration, Oral; Adult; Chickenpox; Diarrhea; Drug Administration Schedule; Fever; Humans; Incidence; Male; Military Personnel; Pruritus; Singapore; Time Factors

1995
Tumor necrosis factor, interleukin-2, and interferon-gamma in adult varicella.
    Journal of medical virology, 1994, Volume: 43, Issue:1

    Adult varicella can be a severe illness complicated by pneumonia, encephalitis, or prolonged fever. This study measured levels of tumor necrosis factor (TNF)-alpha, interleukin-2 (IL-2), and interferon gamma (IFN-G) in a consecutive group of 31 adult varicella patients presenting within 24 hours of rash onset. All cytokines were assayed using an ELISA technique. TNF-alpha was detectable in 71% of patients with a mean level of 52 pg/ml. IL-2 was detectable in 29% with a mean level of 1040 pg/ml. IFN-gamma was detectable in only 9%. There was no correlation between TNF, IL-2, or IFN-G level and clinical severity as determined by duration and severity of cutaneous findings, duration of fever, frequency of hepatitis, or thrombocytopenia.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Enzyme-Linked Immunosorbent Assay; Humans; Interferon-gamma; Interleukin-2; Prospective Studies; Tumor Necrosis Factor-alpha

1994
[Clinical evaluation of aciclovir granules in the treatment of chickenpox in otherwise healthy children].
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 1994, Volume: 68, Issue:2

    The efficacy and safety of aciclovir granules (containing 40% w/w aciclovir) were evaluated in the treatment of chickenpox in otherwise healthy children. Patients presenting with chickenpox received aciclovir granules at a dose of 20 mg/kg four times daily for five to seven days. Overall 51 children received treatment with aciclovir. A further 53 patients receiving conventional symptomatic therapy acted as a control. In the aciclovir group the overall efficacy rate was 92.2%. There were reductions in the numbers of lesions, fever, itching and the duration of symptoms. No adverse experiences were reported. Overall this formulation of aciclovir appears to be a safe and effective treatment for chickenpox in this patient population. However the need for anti-viral therapy in otherwise healthy children is still the subject of debate and it might be appropriate to identify sub-groups for whom such therapy is justified.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Dosage Forms; Female; Humans; Infant; Male

1994
Immune responses to varicella zoster virus infections in healthy children.
    The Journal of infectious diseases, 1993, Volume: 167, Issue:1

    The immune responses to varicella zoster virus were studied in 67 otherwise normal children participating in a placebo-controlled trial of acyclovir for the treatment of chickenpox. No differences were observed between acyclovir and placebo groups. Children were studied longitudinally, at onset of chickenpox, and at 1 month, 3 months, 1 year, and 3 years after infection. These data help define the natural history of the immune response to chickenpox in children.

    Topics: Acyclovir; Adolescent; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Herpesvirus 3, Human; Humans; Interferon-gamma; T-Lymphocytes

1993
Oral acyclovir to prevent dissemination of varicella in immunocompromised children.
    The Journal of infection, 1993, Volume: 26, Issue:1

    Twenty-five immunocompromised children with varicella were treated with oral acyclovir 800 mg, five times daily for 7 days. Two patients were transferred from the oral to the intravenous route: one had signs of varicella pneumonitis on routine X-ray, the other had continuing new lesion formation on day 4 of oral treatment. The disease healed in all patients, with no other evidence of dissemination. In an historical placebo treated group, 12 of 25 patients were transferred to intravenous acyclovir. The reduction to two of 25 is statistically significant (P < 0.01). The mean peak plasma acyclovir concentration in these patients was 6.56 mumol/l. Mild, self-limiting diarrhoea in nine patients was the only adverse event considered to be related to acyclovir. It is concluded that immunocompromised children with varicella can be treated safely and effectively with oral acyclovir. All patients should be observed closely by a physician.

    Topics: Acyclovir; Administration, Oral; Adolescent; Chickenpox; Child; Child, Preschool; Female; Humans; Immunocompromised Host; Infant; Infusions, Intravenous; Male; Pneumonia, Viral

1993
Acyclovir treatment of varicella in otherwise healthy adolescents. The Collaborative Acyclovir Varicella Study Group.
    The Journal of pediatrics, 1992, Volume: 120, Issue:4 Pt 1

    To determine whether orally administered acyclovir is of therapeutic benefit for varicella in otherwise healthy adolescents, and to compare the severity of the disease in adolescents with that in younger children.. Multicenter, randomized, placebo-controlled, double-blind trial.. Patients' homes and university hospital clinics.. Sixty-eight adolescents between 13 and 18 years of age with varicella entered the study. Of the 62 adolescents with laboratory-confirmed varicella who were included in the final analysis, 31 received acyclovir and 31 received placebo.. Placebo or an 800 mg acyclovir tablet was given orally four times daily for 5 days, beginning within 24 hours of onset of rash.. Acyclovir recipients had significant reductions in times to cessation of new lesion formation (p less than 0.001), maximum number of lesions (p = 0.019), and defervescence (p = 0.045). Mean constitutional illness score was significantly reduced on day 4 (0.5 vs 1.5, p = 0.05), as was the mean number of residual hypopigmented lesions present on 28-day follow-up examination (22.7 vs 92.7, p = 0.018). Two complications, both bacterial superinfections, occurred in placebo recipients. Adverse experiences and varicella-zoster virus antibody titers measured 28 days after enrollment were similar in both treatment groups. Comparison of placebo recipients with children 2 to 12 years of age participating in a companion study indicated that varicella is more severe in adolescents: mean maximum total lesions (421 vs 347, p = 0.003), mean maximum constitutional illness score (3.1 vs 2.2, p = 0.032), and mean number of residual lesions (92.7 vs 33.2, p = 0.01) were all greater in the adolescent population.. Oral acyclovir therapy is safe and effective for treatment of varicella in otherwise healthy adolescents; this may be an appropriate subgroup for treatment with antiviral drugs because the disease is more severe in them than in younger children.

    Topics: Acyclovir; Adolescent; Age Factors; Chickenpox; Child; Child, Preschool; Double-Blind Method; Family; Female; Herpesvirus 3, Human; Humans; Immunity, Cellular; Male; Severity of Illness Index; Superinfection; Treatment Outcome

1992
Treatment of adult varicella with oral acyclovir. A randomized, placebo-controlled trial.
    Annals of internal medicine, 1992, Sep-01, Volume: 117, Issue:5

    To assess the efficacy of oral acyclovir in treating adults with varicella and to describe the natural history of adult varicella.. Double-blind, placebo-controlled randomized trial.. A naval hospital.. One hundred forty-eight of 206 consecutive adult active duty Navy and Marine Corps personnel who were hospitalized for isolation and inpatient therapy of varicella and who could be treated within 72 hours of rash onset completed the study. The diagnosis of varicella was confirmed by acute and convalescent serology in 143 of 144 patients with available paired sera.. Patients were randomly assigned to receive either acyclovir, 800 mg orally five times per day for 7 days, or an identical placebo. Separate randomization codes were used for patients presenting within 24 hours of rash onset and for those presenting 25 to 72 hours after rash onset.. Daily lesion counts, symptom scores, temperature measurements, and laboratory tests were used to monitor the course of the illness.. Early treatment (initiated within 24 hours of rash onset) reduced the total time to (100%) crusting from 7.4 to 5.6 days (P = 0.001) and reduced the maximum number of lesions by 46% (P = 0.04). Duration of fever and severity of symptoms were also reduced by early therapy. Late therapy (25 to 72 hours after rash onset) had no effect on the course of illness. Only four patients had pneumonia, and no encephalitis or mortality was noted.. Early therapy with oral acyclovir decreases the time to cutaneous healing of adult varicella, decreases the duration of fever, and lessens symptoms. Initiation of therapy after the first day of illness is of no value in uncomplicated cases of adult varicella. The low frequency of serious complications of varicella (pneumonia, encephalitis, or death) precluded any evaluation of the possible effect of acyclovir on these outcomes.

    Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Antibodies, Viral; Chickenpox; Double-Blind Method; Female; Fever; Herpesvirus 3, Human; Humans; Immunoglobulin G; Male; Skin Diseases, Infectious

1992
A double blind, placebo controlled trial of efficacy and safety of oral acyclovir (Zovirax) in the treatment of chickenpox in adults.
    Rivista europea per le scienze mediche e farmacologiche = European review for medical and pharmacological sciences = Revue europeenne pour les sciences medicales et pharmacologiques, 1992, Volume: 14, Issue:1

    A double-blind placebo controlled trial of oral acyclovir in otherwise healthy immune competent young adults with chickenpox was conducted. One hundred males were recruited into the trial, fifty were randomised to receive acyclovir at a dose of 800 mg five times daily for 5 days and fifty to receive matching placebo. Acyclovir recipients experienced itching and required anti-pruritic therapy for a significantly shorter period of time (p less than 0.05); no significant effects of acyclovir therapy on overall rash progression were observed. In patients with a mild rash on entry the maximum daily temperature recorded was significantly lower in the acyclovir group as compared with placebo recipients on day 1 of therapy (p less than 0.01). Acyclovir was extremely well tolerated and no adverse events were reported. Studies with early oral acyclovir therapy in otherwise healthy children with chickenpox has demonstrated significant benefits, particularly in rash progression. It is postulated that the partial benefits shown in this study in adults reflect the high proportion of patients with mild disease and enrollment of the majority of patients more than 24 hours after the rash onset.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Double-Blind Method; Humans; Male

1992
Chickenpox--examining our options.
    The New England journal of medicine, 1991, Nov-28, Volume: 325, Issue:22

    Topics: Acyclovir; Adult; Chickenpox; Chickenpox Vaccine; Child; Herpes Zoster; Herpesvirus 3, Human; Humans; Leukemia; Vaccination; Viral Vaccines

1991
[Effect of isoprinosine and acyclovir on the clinical course of chickenpox and herpes zoster].
    Przeglad epidemiologiczny, 1991, Volume: 45, Issue:4

    The therapeutic effect of isoprinosine and acyclovir have been studied in 352 and 284 patients with chicken-pox and herpes zoster respectively. The patients were divided into 4 groups: the first one was given palliative treatment only, the second--both palliative and isoprinosine ones, the third--palliative and acyclovir treatment, and the fourth group was given all these. The best therapeutic effect was achieved when acyclovir and isoprinosine was applied jointly, the one of acyclovir alone was less pronounced and that of isoprinosine only was the smallest. According to the authors acyclovir should be the treatment of choice in the very severe and severe cases of chicken-pox and herpes zoster; in the early stage of disease it should be supplemented with isoprinosine and passive immunotherapy.

    Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Aged; Chickenpox; Child; Drug Administration Schedule; Drug Therapy, Combination; Female; Herpes Zoster; Humans; Injections, Intravenous; Inosine Pranobex; Male; Middle Aged; Remission Induction; Time Factors

1991
A controlled trial of acyclovir for chickenpox in normal children.
    The New England journal of medicine, 1991, Nov-28, Volume: 325, Issue:22

    Chickenpox, the primary infection caused by the varicella-zoster virus, affects more than 3 million children a year in the United States. Although usually self-limited, chickenpox can cause prolonged discomfort and is associated with infrequent but serious complications.. To evaluate the effectiveness of acyclovir for the treatment of chickenpox, we conducted a multicenter, double-blind, placebo-controlled study involving 815 healthy children 2 to 12 years old who contracted chickenpox. Treatment with acyclovir was begun within the first 24 hours of rash and was administered by the oral route in a dose of 20 mg per kilogram of body weight four times daily for five days.. The children treated with acyclovir had fewer varicella lesions than those given placebo (mean number, 294 vs 347; P less than 0.001), and a smaller proportion of them had more than 500 lesions (21 percent, as compared with 38 percent with placebo; P less than 0.001). In over 95 percent of the recipients of acyclovir no new lesions formed after day 3, whereas new lesions were forming in 20 percent of the placebo recipients on day 6 or later. The recipients of acyclovir also had accelerated progression to the crusted and healed stages, less itching, and fewer residual lesions after 28 days. In the children treated with acyclovir the duration of fever and constitutional symptoms was limited to three to four days, whereas in 20 percent of the children given placebo illness lasted more than four days. There was no significant difference between groups in the distribution of 11 disease complications (10 bacterial skin infections and 1 case of transient cerebellar ataxia). Acyclovir was well tolerated, and there was no significant difference between groups in the titers of antibodies against varicella-zoster virus.. Acyclovir is a safe treatment that reduces the duration and severity of chickenpox in normal children when therapy is initiated during the first 24 hours of rash. Whether treatment with acyclovir can reduce the rare, serious complications of chickenpox remains uncertain.

    Topics: Acyclovir; Administration, Oral; Chickenpox; Child; Child, Preschool; Double-Blind Method; Female; Humans; Male; Multivariate Analysis; Skin; Time Factors

1991
Acyclovir treatment of varicella in otherwise healthy children.
    The Journal of pediatrics, 1990, Volume: 116, Issue:4

    To determine whether acyclovir administered orally affects the duration and severity of varicella in otherwise normal children.. Randomized, placebo-controlled, double-blind trial.. Patients' residence and university hospital clinic.. One hundred five children between 5 and 16 years of age with laboratory-confirmed varicella entered the study. Of the 102 who were included in the final analysis, 50 received acyclovir and 52 received placebo.. Placebo or acyclovir was given orally four times daily, for 5 to 7 days. The acyclovir dose was adjusted as follows: 5 to 7 years of age, 20 mg/kg; 7 to 12 years, 15 mg/kg; and 12 to 16 years, 10 mg/kg.. Acyclovir recipients, compared with the placebo group, defervesced sooner (median, 1 day vs 2 days; p = 0.001), experienced onset of cutaneous healing sooner, as reflected by a decrease in number of lesions (median, 3 days vs 2 days; p = 0.002), and had fewer skin lesions (median, 500 vs 336; p = 0.02). Acyclovir did not significantly change the rate of complications of varicella (10% in the acyclovir group vs 13.5% among placebo subjects). Adverse drug effects were not observed. Acyclovir recipients had lower geometric mean serum antibody titers to varicella-zoster virus than their placebo counterparts 4 weeks after the onset of illness, but antibody titers in both groups were similar 1 year later.. These results provide evidence that acyclovir is useful and well tolerated for treatment of varicella in otherwise healthy children.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Double-Blind Method; Female; Herpesvirus 3, Human; Humans; Male; Placebos; Pruritus; Randomized Controlled Trials as Topic; Wound Healing

1990
Acyclovir treatment for varicella does not lower gpI and IE-62 (p170) antibody responses to varicella-zoster virus in normal children.
    Journal of clinical microbiology, 1990, Volume: 28, Issue:10

    The varicella-zoster virus (VZV) membrane glycoprotein gpI elicits a major immunoglobulin G antibody response after naturally acquired VZV infection; antibody to a nonglycosylated immediate-early protein, IE-62 (p170), represents a response to a nonmembrane VZV component. We evaluated antibody response to VZV gpI and IE-62 (p170) at 28 days and 1 year following infection in 34 children (ages 5 to 16 years) enrolled in a randomized placebo-controlled study of oral acyclovir for the treatment of varicella. All children were VZV antibody negative at enrollment, were previously healthy, and had laboratory-documented varicella. Compared with placebo recipients, acyclovir recipients had lower geometric mean titers by the fluorescent antibody to membrane antigen technique at 28 days (620 versus 836) but similar titers at 1 year (122 versus 122). All children had antibodies to gpI and IE-62 detectable by enzyme-linked immunosorbent assay at 28 days and 1 year. No difference in gpI at 28 days compared with 1 year was noted in acyclovir recipients. No difference in antibody to IE-62 (p170) was noted when acyclovir and placebo recipients were compared at either 28 days or 1 year. Antibody responses to gpI and IE were similar when children were stratified by age (5 to 6 years, 7 to 11 years, 12 to 16 years). A short course of oral acyclovir for the treatment of varicella did not affect antibody responses to gpI or IE-62 (p170) in healthy children at 28 days and 1 year following varicella.

    Topics: Acyclovir; Adolescent; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Herpesvirus 3, Human; Humans; Immunoglobulin G; Viral Proteins

1990
Acyclovir prevents dissemination of varicella in immunocompromised children.
    The Journal of infectious diseases, 1988, Volume: 157, Issue:2

    Fifty immunocompromised children with varicella who exhibited no signs of dissemination were treated with intravenous acyclovir or placebo in a double-blind, randomized study. Twelve of 25 placebo recipients were withdrawn from treatment because of their deteriorating condition and were given open acyclovir therapy; only one of 25 recipients of acyclovir was similarly withdrawn (P less than .001). Among those patients who did not receive open treatment, acyclovir significantly reduced time to full crusting (P = .01). Overall, acyclovir, as judged by the physician, significantly improved the patients' condition.

    Topics: Acyclovir; Adolescent; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Clinical Trials as Topic; Double-Blind Method; Female; Herpesvirus 3, Human; Humans; Immune Tolerance; Infant; Male; Random Allocation

1988
Management of varicella zoster infections in immunocompetent hosts.
    The American journal of medicine, 1988, Aug-29, Volume: 85, Issue:2A

    Varicella in otherwise healthy children usually requires no antiviral treatment. In severe cases, however, such as are seen in neonates and adults, treatment must be given. Anecdotal evidence suggests the efficacy of intravenous acyclovir in such patients. Herpes zoster in immunocompetent patients may be severe enough to warrant antiviral therapy, particularly in elderly patients. Both idoxuridine and acyclovir have been investigated in placebo-controlled double-blind studies. Due to its low toxicity, ease of administration, and the possibility of systemic administration, acyclovir has largely replaced older antivirals in the management of herpes zoster in the normal host. Recent studies have shown the efficacy of oral acyclovir. In addition, oral acyclovir may prevent the ocular complications of ophthalmic zoster. When acyclovir is given, it should be administered as early as possible, preferably no later than four days after the onset of the rash. The combination of acyclovir and prednisolone for the prevention of post-herpetic neuralgia has not proved effective.

    Topics: Acyclovir; Chickenpox; Clinical Trials as Topic; Herpes Zoster; Humans; Idoxuridine; Immunity; Neuralgia; Prednisolone

1988
Treatment of chickenpox in immunocompromised children.
    The American journal of medicine, 1988, Aug-29, Volume: 85, Issue:2A

    In Hungary since 1981, 98 immunocompromised children have been treated with intravenous acyclovir for varicella zoster virus infections. They were treated in an open study or a double-blind study. Results of both are discussed briefly. Overall, five of 74 patients with varicella died, whereas all 24 patients with herpes zoster recovered. Treatment failures occurred in patients in whom treatment started late and in those with severe lymphocytopenia. In some children, varicella zoster virus-specific antibodies failed to develop by the end of treatment, and a proportion of these suffered recurrent episodes of varicella.

    Topics: Acyclovir; Chickenpox; Child; Clinical Trials as Topic; Double-Blind Method; Humans; Immune Tolerance; Placebos

1988
Current therapy of varicella zoster virus infection in immunocompromised patients. A comparison of acyclovir and vidarabine.
    The American journal of medicine, 1988, Aug-29, Volume: 85, Issue:2A

    Both acyclovir and vidarabine are effective treatment for varicella zoster virus (VZV) infection in immunosuppressed patients. To determine which is preferable, therapy with these two agents was compared in a prospective, randomized trial. A total of 22 immunocompromised patients undergoing treatment for hematologic malignancies and presenting with VZV infection within 72 hours of the onset of rash were randomly assigned to receive intravenous acyclovir or vidarabine; 11 patients were randomly assigned to each treatment group. Acyclovir was significantly more effective than vidarabine in preventing complications of VZV infection, and treatment failures requiring a change to the alternate therapy occurred only among those treated with vidarabine. As compared with vidarabine, acyclovir shortened the median period during which results of viral culture specimens were positive and new lesions formed. Acyclovir also shortened the median interval until the first decrease in pain, the crusting of all lesions, and the complete healing of lesions. Acyclovir is more effective than vidarabine in the treatment of VZV infection in severely immunocompromised patients and should be considered the treatment of choice in such cases.

    Topics: Acyclovir; Adult; Chickenpox; Clinical Trials as Topic; Female; Herpes Zoster; Humans; Immune Tolerance; Male; Prospective Studies; Random Allocation; Risk Factors; Vidarabine

1988
[Results of the antiviral treatment of chickenpox and herpes zoster in children with neoplasms].
    Pediatria polska, 1988, Volume: 63, Issue:9

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Clinical Trials as Topic; Herpes Zoster; Humans; Immune Tolerance; Infant; Neoplasms; Opportunistic Infections

1988
[Acyclovir in the therapy of varicella zoster-caused disease in children undergoing immunosuppressive therapy].
    Orvosi hetilap, 1987, Oct-04, Volume: 128, Issue:40

    Topics: Acyclovir; Chickenpox; Child, Preschool; Clinical Trials as Topic; Double-Blind Method; Drug Evaluation; Drug Interactions; Female; Humans; Immunosuppressive Agents; Infant; Lymphoma; Male; Neoplasms

1987
Clinical and subclinical reactivations of varicella-zoster virus in immunocompromised patients.
    The Journal of infectious diseases, 1986, Volume: 153, Issue:5

    The frequencies of reactivated disease due to varicella-zoster virus (VZV) in immunocompromised patients were determined by enzyme-linked immunosorbent assay for antibody and also by the lymphocyte proliferation response to VZV antigen. Subclinical reactivations were as common as classical herpes zoster in all patient groups. Among bone marrow transplant (BMT) recipients, 36% developed herpes zoster and 26%, a subclinical reactivation. The corresponding frequencies for patients with leukemia during induction therapy were 5% and 10%; in renal transplant recipients, 0% and 26%; and in patients with seminoma, 0% and 6%, respectively. Subclinical reactivation of VZV thus appears to be a common finding in severely immunocompromised patients. A regained lymphocyte proliferation response to VZV antigen is a sensitive indicator of subclinical reactivation of VZV in BMT recipients. None of 19 BMT recipients with subclinical disease due to VZV later developed clinical reactivation of VZV. Acyclovir given as prophylaxis against infection with herpes simplex virus reduced the number of clinical and subclinical reactivations of VZV during treatment in BMT recipients, but not thereafter.

    Topics: Acyclovir; Antibodies, Viral; Antigens, Viral; Bone Marrow Transplantation; Chickenpox; Dysgerminoma; Graft vs Host Disease; Herpes Zoster; Herpesvirus 3, Human; Humans; Immune Tolerance; Immunoglobulin G; Kidney Transplantation; Leukemia; Lymphocyte Activation; Male; Recurrence; Testicular Neoplasms

1986
[Antiviral chemotherapy].
    Monatsschrift Kinderheilkunde : Organ der Deutschen Gesellschaft fur Kinderheilkunde, 1986, Volume: 134, Issue:3

    After a discussion of the principles of antiviral chemotherapy, treatment and chemoprophylaxis of the following virus infections are reviewed in detail: the various manifestations of herpes simplex virus infections, varicella-zoster, cytomegalovirus infections, Epstein-Barr virus infections, laryngeal papillomas, and influenza A. Special reference is made to the treatment of immunocompromized patients. Acycloguanosine (acyclovir) has been found particularly useful in the treatment of herpes simplex virus and varicella zoster virus infections in immunocompromized patients and for herpesencephalitis. Varicella-zoster can also be treated effectively with bromovinyldeoxyuridine (BVDU). Toxicity of the currently used antiviral drugs is discussed as well as the problem of drug resistance.

    Topics: Acyclovir; Antiviral Agents; Bromodeoxyuridine; Chickenpox; Child; Clinical Trials as Topic; Cytomegalovirus Infections; Double-Blind Method; Encephalitis; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Humans; Immunologic Deficiency Syndromes; Infant, Newborn; Pemphigoid Gestationis; Pregnancy; Vidarabine; Virus Diseases

1986
Comparative trial of acyclovir and vidarabine in disseminated varicella-zoster virus infections in immunocompromised patients.
    Journal of medical virology, 1986, Volume: 20, Issue:2

    A comparative assessment of vidarabine and acyclovir in the treatment of varicella and disseminated zoster in immunosuppressed patients was undertaken. Thirty-eight immunosuppressed patients with varicella (N = 18) or disseminated zoster (N = 20) were treated intravenously with 10 mg/kg/day of vidarabine or 30 mg/kg/day of acyclovir for 5 days according to a preestablished code within each diagnosis group--varicella and disseminated zoster. Two deaths, although not directly related to VZV infection, were observed in the vidarabine-treated varicella group. The times to cessation of formation of new lesions and to the disappearance of fever were similar for vidarabine and acyclovir in each group. In the varicella group, VZV was isolated on day 5 in four out of five vidarabine patients versus one out of five acyclovir patients. No severe adverse effects were observed with either drug. Neutropenia present in patients of both drug groups was transitory and most often related to previous cytolytic chemotherapy. These data suggest that either vidarabine or acyclovir could be used in the treatment of severe VZV infections in immunosuppressed patients, although a larger number of patients would be required for definitive conclusion. Because of the large amount of solute required for vidarabine administration, acyclovir may be preferred when the risk of cardiorespiratory failure is high.

    Topics: Acyclovir; Chickenpox; Clinical Trials as Topic; Female; Herpes Zoster; Humans; Male; Neoplasms; Random Allocation; Vidarabine

1986
Antiviral chemotherapy and chemoprophylaxis.
    Science (New York, N.Y.), 1985, Mar-15, Volume: 227, Issue:4692

    Antiviral compounds have been developed for use in chemoprophylaxis and chemotherapy of a variety of infections in humans, including those caused by influenza viruses, respiratory syncytial virus, and herpesviruses. The efficacy of several of these compounds has been demonstrated in rigorously controlled trials. Advances in molecular virology have led to the identification of biochemically defined, virus-specific functions that serve as appropriate targets for the future development of antiviral compounds. Clinical investigators and practicing physicians are now confronting questions previously raised with the use of antibacterial antibiotics. These questions concern appropriate routes of administration for antiviral compounds, optimal dosage regimens, risks of long-term prophylaxis, and the emergence of resistant organisms.

    Topics: Acyclovir; Adult; Aged; Amantadine; Antiviral Agents; Chickenpox; Clinical Trials as Topic; Cytomegalovirus; Encephalitis; Foscarnet; Guanosine Triphosphate; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Infant, Newborn; Infant, Newborn, Diseases; Influenza A virus; Influenza, Human; Phosphonoacetic Acid; Respiratory Tract Infections; Ribavirin; Rimantadine; Vidarabine; Virus Diseases

1985
Therapy for human herpesvirus infections. A perspective.
    The Alabama journal of medical sciences, 1985, Volume: 22, Issue:2

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Clinical Trials as Topic; Encephalitis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Idoxuridine; Infant, Newborn; Infant, Newborn, Diseases; Keratitis, Dendritic; Trifluridine; Vidarabine

1985
Treatment and prevention of virus infections in immunosuppressed patients.
    Antiviral research, 1985, Volume: Suppl 1

    Topics: Acyclovir; Chickenpox; Clinical Trials as Topic; Cytomegalovirus Infections; Double-Blind Method; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Immune Tolerance; Interferon Type I; Recurrence; Vidarabine

1985
Treatment of human herpesvirus infections with special reference to encephalitis.
    The Journal of antimicrobial chemotherapy, 1984, Volume: 14 Suppl A

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Clinical Trials as Topic; Encephalitis; Female; Herpes Genitalis; Herpes Labialis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Idoxuridine; Infant, Newborn; Keratitis, Dendritic; Keratoconjunctivitis; Male; Vidarabine

1984
Intravenous acyclovir therapy for varicella in immunocompromised children.
    The Journal of pediatrics, 1984, Volume: 104, Issue:1

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Clinical Trials as Topic; Female; Humans; Immunocompetence; Infusions, Parenteral; Kidney Diseases; Male; Time Factors

1984
Antiviral drugs today.
    The New Zealand medical journal, 1984, Dec-12, Volume: 97, Issue:769

    Topics: Acyclovir; Administration, Topical; Adolescent; Amantadine; Antiviral Agents; Chickenpox; Child; Clinical Trials as Topic; Encephalitis; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Humans; Idoxuridine; Influenza, Human; Keratitis, Dendritic; Male; Rimantadine; Vidarabine

1984
Acyclovir therapy of varicella-zoster virus infections in immunocompromised patients.
    The Journal of antimicrobial chemotherapy, 1983, Volume: 12 Suppl B

    In a randomized, placebo-controlled, double-blind trial of intravenous acyclovir in the treatment of varicella zoster virus (VZV) infections, 8 of 20 immunocompromised children with varicella received acyclovir (500 mg/m2/dose three times daily for 7 days). There was no significant difference in skin healing between the acyclovir and placebo groups although there was a significant reduction in the incidence of development of pulmonary involvement during acyclovir treatment. Nineteen out of 34 patients received vidarabine (10 mg/kg/day for 5 days). Vidarabine significantly shortened the duration of new vesicle formation. Both drugs significantly reduced the incidence of visceral varicella, the most serious complication of VZV infection. An open trial also concluded that early treatment of varicella in these patients is essential. Of the 94 patients with zoster infection, 52 received acyclovir (500 mg/m2/dose infused over one hour three times daily for 7 days). Acyclovir recipients healed more rapidly, had fewer days of pain and shorter duration of viral shedding compared with placebo patients. The most important finding was that acyclovir significantly protected against progression of zoster as defined by development or progression of cutaneous dissemination and development of visceral zoster. Vidarabine seemed to be equally effective in this respect. The likelihood of cutaneous dissemination is related to the nature of the underlying condition. The in vitro sensitivity of VZV isolates from patients with second episode VZV infection during the trial did not change appreciably which suggests that VZV does not become resistant to acyclovir during therapy.

    Topics: Acyclovir; Adolescent; Adult; Aged; Bone Marrow Transplantation; Chickenpox; Child; Clinical Trials as Topic; Double-Blind Method; Drug Resistance, Microbial; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunosuppression Therapy; Injections, Intravenous; Kidney Transplantation; Lymphoproliferative Disorders; Male; Middle Aged; Neoplasms; Random Allocation; Vidarabine

1983
A randomised controlled study of intravenous acyclovir (Zovirax) against placebo in adults with chickenpox.
    The Journal of infection, 1983, Volume: 6, Issue:1 Suppl

    In a double-blind, randomised, placebo-controlled trial of intravenous acyclovir (ACV) in normal adults with chickenpox, the drug was shown to have a significant effect on the duration of vesicles, on virus counts after one day's treatment and in lowering the body temperature on the third, fourth and sixth days of treatment. There were no significant effects on the duration of symptoms or on the evolution of the rash. No adverse effects of acyclovir were seen.

    Topics: Acyclovir; Adult; Antibodies, Viral; Chickenpox; Clinical Trials as Topic; Female; Humans; Infusions, Parenteral; Male; Random Allocation

1983
[Efficacy and tolerability of acyclovir in immunosuppressed patients with herpes simplex, herpes zoster or cutaneomucous chicken-pox. Multicenter trial apropos of 50 cases].
    La Revue de medecine interne, 1983, Volume: 4, Issue:3

    A multicenter trial of Acyclovir was carried out in 50 immunodepressed patients. The dose used was 15 mg/kg/day for 5 days in herpes simplex and 30 mg/kg/day for 10 days in herpes zoster and chicken pox by three one-hourly intravenous infusion per day. Acyclovir had a clear cut effect in 42 cases, a partial effect in 1 case, no effect in 1 case, and its action could not be assessed in 6 cases. The cutaneous and mucous membrane lesions were stabilised after an average of two days' treatment, and regression was observed from the third day. Of the 21 cases of zoster, 15 were cured without sequellae and 5 with post-zoster pain. The treatment failed in one patient. Of the 21 cases of cutaneous and/or mucous membrane herpes simplex, 20 satisfactory and 1 partial result were obtained. The outcomes of the 2 cases of chicken pox were favourable. There were three relapses after the end of therapy (2 herpes simplex, 1 zoster) but their outcomes were favourable after a second course of Acyclovir. In 20 cases it was possible to maintain the immuno-suppressive therapy. General tolerance was satisfactory.

    Topics: Acyclovir; Adolescent; Adult; Aged; Chickenpox; Child; Clinical Trials as Topic; Female; Herpes Simplex; Herpes Zoster; Humans; Immune Tolerance; Male; Middle Aged; Prognosis

1983
Acyclovir therapy of chickenpox in immunosuppressed children--a collaborative study.
    The Journal of pediatrics, 1982, Volume: 101, Issue:4

    A randomized double-blind, placebo-controlled, multicenter investigation assessed the usefulness of acyclovir in the treatment of immunosuppressed children with chickenpox. Twelve patients received placebo and eight received acyclovir. If the event of clinical deterioration, patients could be removed from the study to receive acyclovir. Eighteen patients had skin lesions within 96 hours of admission to the study. Nineteen patients had malignancies. The two groups of patients were similar in age, in concomitant or preceding immunosuppressive therapy, in status of malignancy, and in presenting granulocyte and lymphocyte counts. Zoster immune globulin or plasma had been given to 50% of the placebo group but to only 25% of the acyclovir group. One patient in each group had pneumonitis at entry. Of the patients without pneumonitis at entry, five of the 11 placebo patients compared with none of the seven acyclovir patients developed pneumonitis during treatment (P = 0.054). No evidence of toxicity related to acyclovir was observed.

    Topics: Acyclovir; Chickenpox; Child; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Immunization, Passive; Immunosuppression Therapy; Male; Neoplasms; Random Allocation

1982
[Acyclovir therapy of varicella-zoster virus infections in the immunosuppressed children ].
    Pathologie-biologie, 1982, Volume: 30, Issue:6 Pt 2

    We evaluated Acyclovir therapy in 16 immunodeficient children with varicella (7 cases) and zoster (9 cases) in a controlled open study. infections were serious in 12 patients. Each patient had daily clinical, biological and virological tests. Sixty minutes intra-venous infusions of Acyclovir were given three times a day (5 to 10 mg/kg/8 hours) for 6 ou 11 days. All patients who received therapy before the first four days, ahd a more rapid cessation of new vesicles formation and more rapid scaring, than those with delayed treatment. Ten controlled children had accelerated clearance of viral antigens from vesicles. In 15 cases, virus was not isolated after the third day. Two children with varicellous interstitial pneumonia died, 8 and 25 days after the end of treatment. Fourteen patients recovered in 8 to 10 days. No relapses of varicella-zoster virus infections had been observed 1 to 14 months after therapy. The drug was well-tolerated, but supervising of renal functions is necessary. Acyclovir had a good therapeutic efficacy to treat chickenpox and shingles in the immunocompromised patients.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Child; Child, Preschool; Clinical Trials as Topic; Female; Herpes Zoster; Humans; Male; Neoplasms

1982

Other Studies

411 other study(ies) available for acyclovir and Chickenpox

ArticleYear
Severe varicella-zoster virus meningoencephalomyelitis coexisting with visceral disseminated varicella-zoster virus infection in a patient with lupus nephritis: A case report.
    Medicine, 2023, Apr-07, Volume: 102, Issue:14

    Meningoencephalomyelitis and visceral dissemination infection are rare but life-threatening complications of either the primary infection or reactivation of varicella-zoster virus (VZV) in immunocompromised patients. To date, few studies have reported the co-existence of VZV meningoencephalomyelitis and the visceral dissemination of VZV infection.. A 23-year-old male was diagnosed with lupus nephritis class III and was being treated with oral prednisone and tacrolimus. The patient exhibited herpes zoster 21-day after the initiation of therapy and experienced unbearable abdominal pain and generalized seizures 11 days after the onset of a zoster rash. Magnetic resonance imaging showed progressive lesions in the cerebrum, brainstem, and cerebellum, as well as meningeal thickening and thoracic myelitis. Computed tomography showed pulmonary interstitial infiltration, partial intestinal dilatation, and effusion. Metagenomic next-generation sequencing revealed 198,269 and 152,222 VZV-specific reads in the cerebrospinal fluid and bronchoalveolar lavage fluid, respectively.. Based on the clinical and genetic findings, this patient was finally diagnosed with VZV meningoencephalomyelitis and visceral disseminated VZV infection.. The patient received intravenous acyclovir (0.5 g every 8 hours) combined with plasma exchange and intravenous immunoglobulin. Treatment against secondary bacterial and fungal infections, organ support therapy and rehabilitation training were given simultaneously.. The patient's peripheral muscle strength did not improve and repeated metagenomic next-generation sequencing showed the persistence of VZV-specific reads in the cerebrospinal fluid. The patient finally abandoned therapy due to financial constraints at the 1-month follow-up.. Patients with autoimmune diseases receiving immunosuppressive therapy should be warned about the possibility of developing serious neurological infections and visceral disseminated VZV infections as side effects. Early diagnosis and the early initiation of intravenous acyclovir therapy are important for such cases.

    Topics: Acyclovir; Adult; Chickenpox; Encephalomyelitis; Herpes Zoster; Herpesvirus 3, Human; Humans; Lupus Nephritis; Male; Varicella Zoster Virus Infection; Young Adult

2023
Aciclovir prophylaxis after varicella zoster exposure in pregnancy.
    Drug and therapeutics bulletin, 2023, Volume: 61, Issue:6

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Pregnancy

2023
A survival case of visceral disseminated varicella zoster virus infection in a patient with systemic lupus erythematosus.
    BMC nephrology, 2023, 06-08, Volume: 24, Issue:1

    Visceral disseminated varicella zoster virus (VZV) infection is a rare but life-threatening complication in immunosuppressed patients. Herein, we report a survival case of visceral disseminated VZV infection in a patient with systemic lupus erythematosus (SLE).. A 37-year-old woman was diagnosed as SLE and initial induction therapy was started. Two months after starting the immunosuppressive therapy consisting of 40 mg of prednisolone (PSL) and 1500 mg of mycophenolate mofetil (MMF) daily, she suddenly developed strong abdominal pain, which was required opioid analgesics, followed by systemic skin blisters, which were diagnosed as varicella. Laboratory findings showed rapid exacerbation of severe liver failure, coagulation abnormalities and increased numbers of blood VZV deoxyribonucleic acid (DNA). Therefore, she was diagnosed as visceral disseminated VZV infection. Multidisciplinary treatment with acyclovir, immunoglobulin and antibiotics was started, the dose of PSL was reduced, and MMF was withdrawn. By their treatment, her symptoms were resolved and she finally discharged.. Our case highlights the importance of a clinical suspicion of visceral disseminated VZV infections, and the necessity of immediate administration of acyclovir and reduced doses of immunosuppressant to save patients with SLE.

    Topics: Acyclovir; Adult; Chickenpox; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Lupus Erythematosus, Systemic; Mycophenolic Acid; Prednisolone; Varicella Zoster Virus Infection

2023
Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
    Pediatric transplantation, 2023, Volume: 27, Issue:6

    Varicella vaccine, a live-attenuated Oka-strain of varicella zoster virus (VZV), is a recommended childhood vaccine by many countries. As with wild varicella strain, after primary infection, the live-attenuated virus can establish latency in sensory ganglia and reactivate causing vaccine-strain illnesses: herpes zoster (HZ), visceral or peripheral and central nervous system dissemination. We report a case of early reactivation of live-attenuated virus-HZ and meningoencephalitis-in an immunocompromised child.. This is a retrospective descriptive report of a case, in a tertiary pediatric hospital, CHU Sainte-Justine (Montréal, Canada).. An 18 month-year old girl diagnosed with a primitive neuro-ectodermal tumor (PNET) received the day prior to diagnosis, a first varicella vaccine (MMRV). She received chemotherapy 20 days post MMRV vaccine and autologous bone marrow transplantation 3 months post vaccination. She was considered not eligible, to acyclovir prophylaxis prior transplantation (positive for VZV IgG and negative for herpes simplex virus IgG by ELISA). At day 1 post transplantation, she developed dermatomal HZ and meningoencephalitis. Oka-strain varicella was isolated, she was treated with acyclovir and foscarnet. Neurologic status improved in 5 days. Control of VZV viral load in cerebrospinal fluid showed a slow decrease to from 5.24 log 10 copies/mL to 2.14 log 10 copies/mL in 6 weeks. No relapse was observed. She recovered without neurological sequelae.. Our experience highlights the importance of conducting a thorough medical history regarding vaccination and serological status of newly immunocompromised patients. Intensive chemotherapy succeeding live vaccine administration <4 weeks could have influenced early and severe viral reactivation. Early initiation of prophylactic antiviral treatment is questioned in such circumstances.

    Topics: Acyclovir; Bone Marrow Transplantation; Chickenpox; Chickenpox Vaccine; Child; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Meningoencephalitis; Retrospective Studies; Vaccines, Attenuated

2023
The Efficacy of Amenamevir for the Treatment of Disseminated Herpes Zoster Complicated with Probable Varicella-zoster Pneumonia in an Immunocompromised Patient.
    Internal medicine (Tokyo, Japan), 2022, Jun-01, Volume: 61, Issue:11

    We herein report the case of a 78-year-old woman who was diagnosed as having disseminated herpes zoster (DHZ) complicated with probable varicella-zoster pneumonia during maintenance therapy for microscopic polyangiitis. Because the patient had severe renal dysfunction, amenamevir administration was started to avoid any neurotoxicity of acyclovir, which is suggested to be optimal for treatment. It ameliorated her symptoms without any adverse events. This is the first report suggesting the efficacy of amenamevir in the treatment of severe herpes zoster infection with coexisting DHZ and probable varicella-zoster pneumonia. Amenamevir could thus be a treatment option for severe varicella zoster virus infections.

    Topics: Acyclovir; Aged; Antiviral Agents; Chickenpox; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Oxadiazoles; Pneumonia; Varicella Zoster Virus Infection

2022
Varicella Zoster With Pemphigus-like Reaction.
    The American Journal of dermatopathology, 2022, Jul-01, Volume: 44, Issue:7

    We present a case of a 55-year-old man with a rash on his right foot that was biopsied and diagnosed as a Varicella Zoster virus infection with an accompanying positive immunohistochemical study with antiviral antibodies. He concomitantly suffered from a Varicella Zoster virus meningitis. The skin biopsies not only showed clear histologic signs of viral cytopathic effects but also showed intercellular IgG and C3 intraepidermal staining by direct immunofluorescence study, findings which are typically consistent with pemphigus vulgaris. However, the patient did not have any history of pemphigus; there was no mucosal involvement, and serum antibodies to desmoglein 1 and 3 were negative. After discharge, the patient continued to have right-sided foot pain, and he continued the acyclovir treatment.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Middle Aged; Pemphigus; Varicella Zoster Virus Infection

2022
Effectiveness of oral aciclovir in preventing maternal chickenpox: A comparison with VZIG.
    The Journal of infection, 2022, Volume: 85, Issue:2

    Although often presenting as a self-limiting childhood disease, chickenpox can have serious consequences if acquired in pregnancy. Until April 2022, the UK recommendations were that varicella immunoglobulin (VZIG) should be administered intramuscularly to susceptible pregnant women exposed to chickenpox prior to 20 weeks gestation. Oral aciclovir or VZIG was recommended if exposure occurred at 20+ weeks gestation. Our objective was to compare the effectiveness of oral aciclovir to VZIG in preventing maternal and neonatal chickenpox.. We identified and followed up 186 pregnant women who were exposed to chickenpox and compared their outcomes.. 171/186 (91.9%) of these women received either VZIG or oral aciclovir. Of the 145 women who received VZIG, 53/145 (36.6%) went on to develop chickenpox compared to 8 of the 26 (30.8%) women who received oral aciclovir (p = 0.32). No statistical difference was found between the oral aciclovir and VZIG groups even after controlling for maternal age, gestational stage, type of exposure and IgG titre (adjusted OR:0.83; 95%CI:0.26-2.65; p = 0.75).. These findings support the use of oral aciclovir as first-line prophylaxis in pregnant women exposed to varicella as they suggest its effectiveness at preventing maternal chickenpox is either better or equal to VZIG.

    Topics: Acyclovir; Antibodies, Viral; Antiviral Agents; Chickenpox; Child; Female; Humans; Immune Sera; Infant, Newborn; Male; Pregnancy

2022
Varicella Pneumonia in an Immunocompetent Middle-aged Adult Male: A Case Report.
    JNMA; journal of the Nepal Medical Association, 2022, Jul-01, Volume: 60, Issue:251

    Varicella pneumonia is uncommon among adults and can present as potentially life-threatening complications of varicella. Here we report a case of a 43-year-old man with no known history of chronic disease and no allergic history who presented to our hospital emergency department with widespread skin eruptions over the entire body and hemoptysis. Varicella pneumonia was diagnosed based on the patient being in contact with his 6-year-old son who had contracted chickenpox 10 days back, typical cutaneous lesions, pulmonary symptoms and radiographic findings. The patient was treated with oral acyclovir and was admitted to the intensive care unit for monitoring. The patient recovered completely after 10 days of treatment.. chickenpox; pneumonia; skin eruptions.

    Topics: Acyclovir; Adult; Chickenpox; Child; Exanthema; Hemoptysis; Humans; Lung; Male; Middle Aged; Pneumonia

2022
Varicella Zoster Viral Retinitis following Chimeric Antigenic Response T-cell Therapy for B-cell Lymphoma.
    Ocular immunology and inflammation, 2022, Volume: 30, Issue:6

    To describe the first case of varicella zoster virus (VZV) retinitis following chimeric antigenic response (CAR) T-cell therapy.. Case review.. A 53-year-old male was treated with CAR T-cell therapy for refractory diffuse large B-cell lymphoma. Nine months after CAR T-cell therapy, he developed VZV skin infection and retinitis. The retinitis responded to systemic acyclovir therapy and intravitreal ganciclovir.. VZV retinitis can occur following CAR T-cell immunotherapy.

    Topics: Acyclovir; Cell- and Tissue-Based Therapy; Chickenpox; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Lymphoma, B-Cell; Male; Middle Aged; Retinitis

2022
Spontaneous Partial Remission in a Child With B-Lineage Acute Lymphoblastic Leukemia and Chickenpox: A Role For Acyclovir?
    Journal of pediatric hematology/oncology, 2021, 07-01, Volume: 43, Issue:5

    A 2.5-year-old boy presented to his pediatrician with progressive pallor, asthenia, fever, splenomegaly, and hematomas. Leukemia was suspected, and a bone marrow aspirate confirmed acute lymphoblastic leukemia. Before chemotherapy induction, the child developed a vesicular rash and was diagnosed clinically with chickenpox. Acyclovir treatment was initiated immediately, whereas induction chemotherapy was postponed by 10 days. At the time of chickenpox resolution, a spontaneous partial recovery of his blood counts and a 50% decrease of blastic bone marrow infiltration were noted. After a brief nonsystematic review, we discuss the potential beneficial effect of acyclovir and chickenpox infection in children with leukemia.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child, Preschool; Herpesvirus 3, Human; Humans; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission, Spontaneous

2021
Low complication rate in immunocompromised children with varicella-zoster virus infections in a single centre.
    Acta paediatrica (Oslo, Norway : 1992), 2020, Volume: 109, Issue:7

    Recent studies focusing on morbidity and mortality rates of immunocompromised children with varicella-zoster virus (VZV) infections are scarce. We aimed to summarise our experience.. The study was a retrospective analysis of the medical records of children, who were admitted to Hadassah-Hebrew University Medical Centre, Jerusalem, Israel, during the period of 2008-2016. Data regarding baseline characteristics, treatment and outcome were extracted from patient's medical files.. We enrolled 74 patients (43% males) with a mean age of 8 (1-19) years. Most patients (72%) had no reported complications. Clinical outcome was favourable with 73 (99%) patients who had completely recovered and none died. Multivariable analysis identified the presence of fever (P = .005 and 0.02; hazard ratio (HR) 7.72 and 17.61, for total and herpes zoster groups, respectively) and prolonged interval period from clinical presentation to treatment onset (P = .021 and 0.025; HR 1.68 and 2.26, respectively), as associated with higher rates of complications.. Our results found low complication rate of VZV-associated infections in immunocompromised children admitted to a single centre. This should encourage conducting further large multicentre studies evaluating management of low-risk patients with oral acyclovir treatment.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Child; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Israel; Male; Retrospective Studies; Young Adult

2020
Varicella under vedolizumab: Should we wait for the disease or propose the vaccine?
    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2020, Volume: 126

    Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Antibodies, Monoclonal, Humanized; Chickenpox; Chickenpox Vaccine; Crohn Disease; Gastrointestinal Agents; Humans; Male

2020
Intravenous acyclovir-induced nephrotoxicity. Is pregnancy a risk factor?
    Journal of gynecology obstetrics and human reproduction, 2020, Volume: 49, Issue:8

    Topics: Acyclovir; Administration, Intravenous; Adult; Antiviral Agents; Chickenpox; Female; Humans; India; Pregnancy; Pregnancy Complications, Infectious; Renal Insufficiency; Risk Factors

2020
Peripheral retinal vasculitis in chickenpox: A case report.
    Indian journal of ophthalmology, 2020, Volume: 68, Issue:9

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Humans; Retinal Vasculitis

2020
Kaposi Varicelliform Eruption Associated With Chickenpox in a Liver Transplant Recipient.
    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2020, Volume: 18, Issue:2

    A 43-year-old male patient developed varicella virus (chickenpox) 4 months after receiving a liver transplant. Within 5 days of complete recovery, he presented with widespread cutaneous vesicular eruptions involving the face, back, abdomen, and upper extremities. Tzanck smear showed ground glass inclusions in the nuclei of multinucleated giant cells, suggestive of viral pathology. The patient was subsequently diagnosed with Kaposi varicelliform eruption, a rare dermatologic emergency. He was treated with high-dose intravenous acyclovir and fully recovered.

    Topics: Acyclovir; Administration, Intravenous; Adult; Antiviral Agents; Chickenpox; Everolimus; Herpesvirus 3, Human; Humans; Immunosuppressive Agents; Kaposi Varicelliform Eruption; Liver Transplantation; Male; Risk Factors; Treatment Outcome

2020
Varicella Pneumonia in an Immunocompetent Adult.
    Journal of general internal medicine, 2019, Volume: 34, Issue:11

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Humans; Male; Pneumonia, Viral; Respiration, Artificial

2019
Herpes Zoster in children: Evaluation of the sixty cases.
    Dermatologic therapy, 2019, Volume: 32, Issue:6

    Herpes Zoster (HZ), caused by the reactivation of the latent Varicella Zoster Virus infection is a disease that may rarely develop in childhood. HZ is considered to be a disease of adult, but recent reports show an increase in the number of cases in childhood. This study was designed to evaluate the demographic and clinical features of children with HZ. Data from patients under 18 years of age that were diagnosed with HZ at two different dermatology outpatient clinics were retrospectively evaluated between October 2012 and December 2018. Out of 60 cases enrolled in the study, 37 were male and 23 were female. The mean age of patients was 8 ± 4.93 years. Of all the cases, 46 had a history of chickenpox. Three patients had been vaccinated against chickenpox. Itching, observed in 48 subjects, was the most common symptom, while 38 subjects complained of pain. Acyclovir was prescribed as antiviral therapy in 33 cases. None of the cases showed any complication. HZ may occur in healthy children without any immunosuppression, too. Pain in children is less common than in adults whereas, itching is more frequent. Complications are rare in these subjects.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Female; Herpes Zoster; Humans; Infant; Male; Retrospective Studies

2019
A case report of severe recurrent varicella in an ankylosing spondylitis patient treated with adalimumab - a new side effect after 15 years of usage.
    BMC infectious diseases, 2019, Feb-07, Volume: 19, Issue:1

    Tumor necrosis factor-α (TNF-α) antagonists, most of which are monoclonal antibodies, became a widespread treatment for autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel diseases, psoriasis, psoriatic arthritis, hidradenitis suppurativa and uveitis. Their use is based on the blockage of TNF-α, which plays an important role in granulomas formation, development of phagosomes, activation and differentiation of macrophages, immune response against viral pathogens. The multiple adverse effects of TNF-α inhibition have been identified, including a two-to four-fold increased risk of active tuberculosis and other granulomatous conditions and an increased occurrence of some other serious bacterial, fungal and certain viral infections.. A 34-year-old male patient with disseminated varicella and pneumonitis was admitted to our hospital. The diagnosis of varicella was established serologically by enzyme immunoassay (EIA) and by polymerase chain reaction confirmation of the virus in vesicular fluid. The patient has been receiving adalimumab and methotrexate for the last 3 years due to ankylosing spondylitis and was seropositive to varicella zoster virus prior to the introduction of TNF-α antagonists. Acyclovir was administered for 10 days with the resolution of clinical illness and radiological signs of pneumonitis.. Due to the use of biological agents, particularly TNF-α inhibitors, as a well-established therapy for some autoimmune diseases, new potential adverse events can be expected in the future and we wanted to point out one of them. To our knowledge this is the first case of recurrent disseminated varicella in a patient taking TNF-α antagonists.

    Topics: Acyclovir; Adalimumab; Adult; Anti-Inflammatory Agents; Chickenpox; Herpesvirus 3, Human; Humans; Male; Methotrexate; Pneumonia; Spondylitis, Ankylosing

2019
Fever and Rash in an Adult: Varicella Re-infection in Conjunction with Newly Diagnosed Chronic Lymphocytic Leukemia.
    The American journal of medicine, 2019, Volume: 132, Issue:6

    Topics: Acyclovir; Adenine; Adult; Antiviral Agents; Chickenpox; Dermatitis; Fever; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Piperidines; Pyrazoles; Pyrimidines

2019
Vaccine-derived varicella zoster infection in a kidney transplant recipient after zoster vaccine live administration.
    Vaccine, 2019, 06-12, Volume: 37, Issue:27

    A 49-year-old kidney transplant recipient, presented with a skin rash, and interstitial infiltrates three weeks after receiving a live attenuated varicella-zoster vaccine. Varicella-zoster Oka-vaccine strain was detected in plasma by polymerase chain reaction and sequencing analysis targeting open reading frame 62 (ORF 62). She was treated successfully with intravenous acyclovir. Our case report supports the current contraindication of live attenuated varicella-zoster vaccine in the solid-organ transplant recipients. Recombinant subunit varicella-zoster vaccine may be the vaccine of choice in these patients; nevertheless, further information is required to establish its safety, efficacy, and optimal timing.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Female; Herpesvirus 3, Human; Humans; Kidney Transplantation; Middle Aged; Plasma; Polymerase Chain Reaction; Sequence Analysis, DNA; Transplant Recipients; Treatment Outcome

2019
Successful Prevention of Varicella Outbreak With Oral Aciclovir Following Party for Pediatric Oncology Patients.
    Journal of pediatric hematology/oncology, 2018, Volume: 40, Issue:6

    Topics: Acyclovir; Administration, Oral; Chickenpox; Child; Child, Preschool; Disease Outbreaks; Female; Humans; Infant; Male; Neoplasms

2018
Varicella-zoster virus necrotising retinitis, retinal vasculitis and panuveitis following uncomplicated chickenpox in an immunocompetent child.
    BMJ case reports, 2018, Apr-05, Volume: 2018

    A 4-year-old girl presented with acute left visual loss 4 weeks after uneventful chickenpox. She was found to have left necrotising retinitis and profound retinal vasculitis and vitritis. Aqueous humour was PCR positive for varicella-zoster virus. Combined intravenous and intravitreal antiviral treatment led to rapid improvement with settled retinitis, no vascular occlusion and good recovery of vision. Her recent coinfection with Epstein-Barr virus may have acted to provoke the retinitis.

    Topics: Acyclovir; Antiviral Agents; Aqueous Humor; Chickenpox; Child, Preschool; Female; Herpes Zoster Ophthalmicus; Humans; Panuveitis; Retinal Necrosis Syndrome, Acute; Retinal Vasculitis; Treatment Outcome; Vision Disorders

2018
Early Treatment Was Life Saving in Varicella Pneumonia of an Immunocompetent Adult.
    Archives of Iranian medicine, 2018, 05-01, Volume: 21, Issue:5

    Chickenpox, an infection of childhood with vesicular skin rash, is caused by varicella-zoster virus (VZV). Although the infection is rare in adults, it can cause serious complications Varicella pneumonia is the most encountered complication. In this report, a VZV pneumonia case in a previously healthy adult is presented. The patient was treated with early intravenous acyclovir and both clinical and radiographic recovery has been observed.

    Topics: Acyclovir; Administration, Intravenous; Adult; Antiviral Agents; Chickenpox; Female; Humans; Immunocompetence; Pneumonia, Viral

2018
Unusual cause of brachial palsy with diaphragmatic palsy.
    BMJ case reports, 2018, May-12, Volume: 2018

    We report a preterm neonate born with respiratory distress. The neonate was found to have diaphragmatic palsy and brachial palsy. The neonate was born by caesarean section and there was no history of birth trauma. On examination, there was bilateral congenital talipes equinovarus and a scar was present on the forearm. The mother had a history of chickenpox during the 16 weeks of pregnancy for which no treatment was sought. On investigation, PCR for varicella was found to be positive in the neonate.

    Topics: Acyclovir; Anti-Bacterial Agents; Brachial Plexus Neuropathies; Casts, Surgical; Cesarean Section; Chickenpox; Clubfoot; Female; Fetal Diseases; Forearm; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Mothers; Pregnancy; Pregnancy Complications, Infectious; Respiratory Paralysis; Treatment Outcome

2018
[Ophthalmic zoster: an uncommon dermatosis in infants].
    The Pan African medical journal, 2018, Volume: 29

    We here report the case of a 9-month infant, born to a mother with a history of varicella in the third trimester of pregnancy but with no history of atopy, admitted to the emergency room with painful, pruritic rash in the right hemiface that had been ongoing for 4 days. During physical examination, the infant appeared to be in pain, with multiple cluster of grouped vesicles on erythematous skin in the right hemiforehead, in the right side of the nose and in the right cheek associated with edema of the upper and lower eyelids, with difficulty opening eyes and purulent conjunctival secretions. The infant was afebrile and in a good general condition. Ophthalmologic examination using the slit-lamp and fundus examination were normal. Complete blood count was normal. The diagnosis of ophthalmic zoster was retained on the basis of the clinical appearance of the lesions. The infant was treated with intravenous Aciclovir for 10 days associated with symptomatic local antiseptic treatment. Patient's evolution was marked by the regression of vesicular lesions and of edema. Viral serologic test and rapid HIV test were negative. The particularity of our study is the occurrence of ophthalmic zoster in an immunocompetent infant, which is rare in children. We made three differential diagnoses which included Kaposi-Juliusberg syndrome, cutaneous infection due to herpes simplex virus and facial erysipelas.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Diagnosis, Differential; Female; Herpes Zoster Ophthalmicus; Humans; Infant; Infectious Disease Transmission, Vertical; Male; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, Third

2018
Atypical, severe presentation of chickenpox.
    World journal of pediatrics : WJP, 2018, Volume: 14, Issue:6

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child, Preschool; Humans; Male

2018
Post Varicella Zoster Acute Transverse Myelitis.
    The Journal of the Association of Physicians of India, 2018, Volume: 66, Issue:8

    Topics: Acyclovir; Chickenpox; Herpes Zoster; Humans; Myelitis, Transverse; Varicella Zoster Virus Infection

2018
Varicella zoster virus infection after allogeneic hematopoietic cell transplantation in children using a relatively short duration of acyclovir prophylaxis: A retrospective study.
    Medicine, 2017, Volume: 96, Issue:14

    Although acyclovir prophylaxis against varicella zoster virus (VZV) infection for ≥1 year is recommended after allogeneic hematopoietic cell transplantation (HCT), the emergence of acyclovir-resistant viruses and adverse drug effects cannot be ignored. We investigated the cumulative incidence of VZV infection after allogeneic HCT in children receiving a shorter duration of acyclovir prophylaxis than recommended and evaluated the appropriateness of the short duration of acyclovir prophylaxis.Medical records of 217 children who received allogeneic HCT were retrospectively reviewed until a median of 25 months (range = 1-59 months) after HCT. Acyclovir prophylaxis was given for a median of 9 weeks (range = 3-24 weeks) after HCT.VZV infection was diagnosed in 33 (15.2%) children at a median time of 5 months (range = 2-41 months) after HCT. The 1-year and 2-year cumulative incidences of VZV infection after allogeneic HCT were 11.2% and 15.5%, respectively. These incidences were between the previously reported 1-year incidence of 25% to 30% in patients not receiving prophylaxis and 1-year incidence of 4% to 5% in patients receiving ≥1 year duration of prophylaxis. Male sex and older age were significantly associated with VZV infection after allogeneic HCT. Only 1 chickenpox patient experienced severe complications because of VZV infection, and there were no deaths attributable to VZV infection.In conclusion, a shorter duration of acyclovir prophylaxis may be appropriate for children receiving allogeneic HCT, based on the rare occurrence of severe complications because of VZV infection and the expected discomfort because of daily oral medication for a long time.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Female; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Male; Postoperative Complications; Republic of Korea; Retrospective Studies; Transplantation, Homologous; Young Adult

2017
Herpes zoster following varicella vaccination in children.
    Cutis, 2017, Volume: 99, Issue:3

    Herpes zoster (HZ), or shingles, is commonly seen in older adults but does occur in children. Routine administration of the varicella vaccine started in 1995 in the United States; since then, the incidence of varicella and HZ has declined. We report a case of HZ in an otherwise healthy 19-month-old boy who had been vaccinated at 13 months of age and recovered fully after acyclovir treatment. We review previously reported cases of HZ in healthy vaccinated children.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Herpes Zoster; Humans; Infant; Male

2017
[Varicella gastritis under immunosuppression : Case report of a woman after lung transplantation due to granulomatosis with polyangiitis].
    Der Internist, 2017, Volume: 58, Issue:8

    A 35-year-old woman who had previously undergone a lung transplantation presented with severe abdominal pain and vomiting. The gastroscopy showed diffuse ulcerative gastric lesions. Tests for varicella zoster virus and Epstein-Barr virus via polymerase chain reactions (PCR) on endoscopically obtained gastric biopsies were found to be positive and confirmed varicella gastritis. Intravenous antiviral therapy with acyclovir was administered resulting in a normalization of all clinical symptoms, especially of abdominal pain and inflammation parameters.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Gastritis; Granulomatosis with Polyangiitis; Herpesvirus 3, Human; Humans; Immunocompromised Host; Lung Transplantation

2017
Varicella Zoster Virus-Associated Necrotizing Retinitis After Chickenpox in a 10-Year-Old Female: A Case Report.
    The Pediatric infectious disease journal, 2017, Volume: 36, Issue:10

    A necrotizing retinitis in children is a rare but vision-threatening ocular complication of chickenpox. We report a 10-year-old girl who developed chickenpox 1 month before presenting with panuveitis and necrotizing retinitis. After prompt antiviral treatment, her inflammatory signs were resolved. Early detection and treatment of varicella zoster-associated necrotizing retinitis after chickenpox can achieve good visual outcome.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Eye Infections, Viral; Female; Herpesvirus 3, Human; Hospitalization; Humans; Retina; Retinal Necrosis Syndrome, Acute

2017
Too young to be vaccinated: hospitalizations caused by varicella among children in the first year of life.
    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2017, Volume: 62

    The aim of this study was to analyse the causes of hospitalization in the course of varicella in children during the first year of life.. An analysis was performed of the medical documentation of 359 children hospitalized for varicella on the infectious diseases ward at the Children's Hospital in Poznan (Poland) between January 2007 and August 2015.. Of the 359 children in the study group, 96 were younger than 1 year old. The most common cause of hospitalization was respiratory infections, found in 31 (32%) children. A severe course of varicella was observed in 38 (14%) children, and 21 (22%) developed skin infections, while 11 (11%) exhibited more than one complication. Treatment with acyclovir was implemented in 90 cases and parenteral antibiotic therapy was applied in 49 children. Contact with siblings suffering from varicella was confirmed in 46 children; for 16, the source of the infection was the mother.. The main source of varicella virus among hospitalized children in the first year of life is home contact. An infant may become infected from its mother suffering from zoster. Children who are exclusively breastfed and are born of mothers who have previously had varicella may develop varicella with a severe course during the first year of life.

    Topics: Acyclovir; Age Factors; Chickenpox; Chickenpox Vaccine; Female; Herpesvirus 3, Human; Hospitalization; Hospitals; Humans; Infant; Infant, Newborn; Male; Poland; Respiratory Tract Infections; Retrospective Studies

2017
Two types of varicella zoster in one patient.
    BMJ case reports, 2017, Sep-19, Volume: 2017

    Topics: Acyclovir; Aged; Antiviral Agents; Chickenpox; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompetence; Male; Real-Time Polymerase Chain Reaction; Varicella Zoster Virus Infection

2017
[A woman with skin rash and dyspnoea].
    Nederlands tijdschrift voor geneeskunde, 2017, Volume: 161

    We present a 36-year-old woman who was born and raised in Hongkong but currently lived in the Netherlands. She was admitted with a varicella-zoster virus (VZV) primo-infection complicated by pneumonia and hepatitis. The patient was successfully treated with aciclovir. Adult VZV primo-infections are uncommon in Dutch natives but occur more often in immigrants from countries with a temperate climate where less people are infected during childhood.

    Topics: Acyclovir; Adult; Chickenpox; Dyspnea; Exanthema; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Netherlands; Treatment Outcome; Varicella Zoster Virus Infection

2017
Chickenpox: an ageless disease.
    BMJ case reports, 2017, Dec-22, Volume: 2017

    A 97-year-old woman presented with 4-day history of vesicular rash, initially at the feet but then spread up to the thighs bilaterally, abdomen and trunk. The initial differentials included bullous pemphigus and cellulitis by the emergency department. She was then managed as bullous pemphigus by the acute medical team and started on high-dose steroids, with no other differentials considered. When her care was taken over by the general medical team, varicella zoster virus (VZV) infection was suspected. After confirmation by the dermatology team regarding the clinical diagnosis and the positive VZV DNA swabs, she was started on acyclovir.

    Topics: Acyclovir; Administration, Intravenous; Aged, 80 and over; Antiviral Agents; Chickenpox; Diagnosis, Differential; Exanthema; Fatal Outcome; Female; Fever; Heart Failure; Herpesvirus 3, Human; Humans

2017
[Perinatal varicella: fetal and neonatal risks and management].
    The Pan African medical journal, 2017, Volume: 28

    The occurrence of clinical varicella during pregnancy is rare but it may pose maternal and fetal risks. Perinatal maternal varicella may result in potentially severe neonatal varicella, especially when maternal eruptions occur between 5 days before and 2 days after delivery. We report eight cases of newborns of mothers with varicella in the peri-partum period in order to synthesize the current state of knowledge on the risk of contracting virus as well as to develop treatment protocol. We conducted a descriptive study at the Maternity and Neonatology Center, Sousse, over a period of 10 years. Eight newborns were included in the study. Prenatal diagnosis was made in 7 mothers. Only a woman developed varicella 3 days after delivery. Five newborns were symptomatic on admission. All newborns had typical varicella skin lesions, three of them had respiratory distress associated. Treatment was based on newborn isolation, local skin care and Acyclovir therapy. Patients evolution was favorable. The occurrence of varicella infection during pregnancy remains possible in the countries where vaccination is still not accessible to all. The risk of maternal and fetal complications justifies specific and well codified treatment

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious; Prenatal Diagnosis; Retrospective Studies; Severity of Illness Index; Time Factors; Treatment Outcome

2017
Idiopathic segmental anhidrosis associated with varicella.
    The Journal of dermatology, 2017, Volume: 44, Issue:2

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Herpesvirus 3, Human; Humans; Hyperhidrosis; Hypohidrosis; Male; Treatment Outcome

2017
Varicella paediatric hospitalisations in Belgium: a 1-year national survey.
    Archives of disease in childhood, 2016, Volume: 101, Issue:1

    Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period.. Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash.. Participation of 101 hospitals was obtained, covering 97.7% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/10(5) person-years, with the highest impact among those 0-4 years old (global incidence and odds of hospitalisation: 79/10(5) person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had ≥1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/552) received acyclovir. Incidence of complicated hospitalised cases was 19/10(5) person-years. Paediatric intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/10(6) and fatality ratio 0.2% among our cohort.. Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Belgium; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Comorbidity; Drug Utilization; Female; Health Surveys; Hospitalization; Humans; Infant; Infant, Newborn; Male; Prognosis; Vaccination

2016
Varicella zoster virus: a rare cause of acute pancreatitis in an immunocompetent child.
    BMJ case reports, 2016, Jan-13, Volume: 2016

    A 15-year-old girl with a diagnosis of varicella zoster virus (VZV) presented to hospital with severe abdominal pain. This patient was immunocompetent and found to have acute pancreatitis in association with VZV. She responded well to intravenous acyclovir and supportive treatment. A review of the literature for the management of pancreatitis associated with VZV suggests treatment with acyclovir, as it appears to reduce hospital stay and symptoms. The exact benefit is yet to be quantified. Importantly, this diagnosis should be considered in children who have VZV associated with abdominal pain.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Female; Herpesvirus 3, Human; Humans; Immunocompetence; Pancreatitis

2016
Gastric varicella: two cases in cancer patients.
    Revista espanola de enfermedades digestivas, 2016, Volume: 108, Issue:10

    Gastric involvement with the varicella-zoster virus is an uncommon clinical condition where early suspicion and diagnosis are important to prevent the consequences deriving from its high morbidity and mortality, which in immunocompromised patients oscillate between 9% and 41% according to the various series. Two cases of gastric involvement with the varicella-zoster virus (VZV) in two patients with blood cancer are reported below. Gastric lesions are usually preceded by typical papulovesicular skin lesions. When gastric involvement is the first symptom of the disease its diagnosis and management may be delayed, which may entail severe consequences for immunocompromised patients. It is therefore that we suggest its inclusion in the algorithm for immunocompromised patients with abdominal pain and ulcer-like endoscopic lesions.

    Topics: Abdominal Pain; Acyclovir; Antiviral Agents; Chickenpox; Female; Hematologic Neoplasms; Humans; Immunocompromised Host; Middle Aged; Stomach Diseases

2016
Clinical course and therapeutic approach to varicella zoster virus infection in children with rheumatic autoimmune diseases under immunosuppression.
    Pediatric rheumatology online journal, 2016, Jun-02, Volume: 14, Issue:1

    To analyze the clinical presentation and complications of varicella zoster virus (VZV) infection in children with rheumatic diseases treated with immunosuppressive medication such as biological disease-modifying antirheumatic drugs (bDMARDs) and/or conventional disease-modifying antirheumatic drugs (cDMARDs), and to analyze the therapeutic approach to VZV infections with respect to the concomitant immunosuppressive treatment.. Retrospective multicenter study using the Swiss Pediatric Rheumatology registry. Children with rheumatic diseases followed in a Swiss center for pediatric rheumatology and treated with cDMARD and/or bDMARD with a clinical diagnosis of varicella or herpes zoster between January 2004 and December 2013 were included.. Twenty-two patients were identified, of whom 20 were treated for juvenile idiopathic arthritis, 1 for a polyglandular autoimmune syndrome type III, and 1 for uveitis. Of these 22 patients, 16 had varicella and 6 had herpes zoster. Median age at VZV disease was 7.6 years (range 2 to 17 years), with 6.3 years (range 2 to 17 years) for those with varicella and 11.6 years (range 5 to 16 years) for those with herpes zoster. The median interval between start of immunosuppression and VZV disease was 14.1 months (range 1 to 63 months). Two patients had received varicella vaccine (1 dose each) prior to start of immunosuppression. Concomitant immunosuppressive therapy was methotrexate (MTX) monotherapy (n = 9) or bDMARD monotherapy (n = 2), or a combination of bDMARD with prednisone, MTX or Leflunomide (n = 11). Four patients experienced VZV related complications: cellulitis in 1 patient treated with MTX, and cellulitis, sepsis and cerebellitis in 3 patients treated with biological agents and MTX combination therapy. Six children were admitted to hospital (range of duration: 4 to 9 days) and 12 were treated with valaciclovir or aciclovir.. The clinical course of varicella and herpes zoster in children under immunosuppression is variable, with 4 (18 %) of 22 children showing a complicated course. Thorough assessment of VZV disease and vaccination history and correct VZV vaccination according to national guidelines at diagnosis of a rheumatic autoimmune disease is essential to minimize VZV complications during a later immunosuppressive treatment.

    Topics: Acyclovir; Adolescent; Antirheumatic Agents; Antiviral Agents; Arthritis, Juvenile; Chickenpox; Child; Child, Preschool; Etanercept; Female; Herpes Zoster; Humans; Immunocompromised Host; Immunosuppressive Agents; Isoxazoles; Leflunomide; Male; Methotrexate; Retrospective Studies; Treatment Outcome; Valacyclovir; Valine; Young Adult

2016
Incidence and consequences of varicella in children treated for cancer in Guatemala.
    World journal of pediatrics : WJP, 2016, Volume: 12, Issue:3

    Varicella-zoster virus infection is associated with significant morbidity and mortality in immune-compromised children, despite treatment with antiviral agents. Universal varicella vaccine programs have significantly decreased this risk in many highincome countries, but in most low-income and middleincome countries, the burden of varicella in children treated for malignancy is poorly defined.. We retrospectively reviewed records of children at the National Unit of Pediatric Oncology (UNOP) in Guatemala diagnosed with varicella between January 2009 and March 2013 in order to calculate incidence of varicella and evaluate morbidity, mortality, treatment interruption, and cost.. Fifty-nine cases of varicella were identified. Incidence was 23.4 cases per 1000 person-years (p-y). 66.1% of cases occurred in children with leukemia (median age 5.2 years; interquantile range 3.4-7 years) and 41.0% of these occurred during maintenance therapy. Source of exposure was identified for 14/59 (23.7%) children. Most were hospitalized (71.2%) and given intravenous acyclovir (64.4%). Eight (13.6%) children required critical care, and two (3.4%) died from disseminated varicella with multiorgan failure. Chemotherapy was delayed or omitted due to varicella in 50%. No significant differences in outcomes based on nutritional and immunologic status were detected. The minimum average cost of treatment per episode was 598.75 USD.. Varicella is a significant problem in children treated for cancer in Guatemala, where effective post-exposure prophylaxis is limited. In the absence of universal varicella vaccination, strategies to improve recognition of exposure and the future use of novel inactivated vaccines currently under investigation in clinical trials could mitigate this burden.

    Topics: Acyclovir; Adolescent; Age Distribution; Antineoplastic Agents; Chickenpox; Child; Child, Preschool; Comorbidity; Databases, Factual; Developing Countries; Female; Follow-Up Studies; Guatemala; Humans; Incidence; Infant; Infusions, Intravenous; Male; Needs Assessment; Neoplasms; Retrospective Studies; Risk Assessment; Sex Distribution; Survival Rate; Treatment Outcome

2016
Prevalence and Outcome of Disseminated Varicella Zoster Infection Post Kidney Transplantation.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016, Volume: 99, Issue:4

    Varicella zoster (VZV) is a potentially life-threatening infection after kidney transplantation (KT) but data on the incidence and outcome of late KT VZV infection is limited.. A retrospective study of disseminated VZV infection (D-VZV) in post KT patients was conducted between 2003 and 2013. Acyclovir prophylaxis was given routinely for six months after KT Statistical analyses were performed by SPSS software version 17.0.. Prevalence of D-VZV was 2% [22/1,032 patients]. Patients median age were 40 (21-67) years old and 12 (55%) were male. Timing of the infection was mostly (68.2%) late (> 1 year) post KT The majority of maintenance immunosuppressive drug included prednisolone (95.5%), cyclosporine (77.3%), mycophenolate (68.2%). Two (9.1%) had a recent VZV exposure and four (18%) received intensified immunosuppression before the diagnosis. Common clinical presentations were lymphopenia (54.5%), generalized vesicular rash (50%), and multi-dermatomal distribution (50%) while liver involvement was infrequent (9.1%). None had pneumonitis or neurological involvement. All cases received systemic acyclovir with the median duration of 14 (3-31) days. One had received IVIG for fulminant hepatitis. Immunosuppressive drug/s was reduced in 59%. Median duration of hospitalization was seven (3-37) days. None of patients died. The median follow-up duration was 1939 (IQR 804-2440) days. Recurrent infection was uncommon (4.5%). Secondary prophylaxis was given only in one patient with fulminant VZV hepatitis.. Incidence of D-VZV post KT was low. Treatments with intravenous acyclovir and reduction of immunosuppression without the use of VZV IgG provided favorable outcome in resource-limited settings.

    Topics: Acyclovir; Adult; Aged; Antiviral Agents; Chickenpox; Female; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Middle Aged; Prevalence; Retrospective Studies; Treatment Outcome; Young Adult

2016
Acyclovir-induced nephrotoxicity in a pregnant woman with chickenpox.
    Taiwanese journal of obstetrics & gynecology, 2016, Volume: 55, Issue:4

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Kidney Diseases; Pregnancy; Pregnancy Complications; Pregnancy Complications, Infectious

2016
Prise en charge de l'infection à la varicelle pendant la grossesse.
    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2016, Volume: 38, Issue:12S

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Herpesvirus 3, Human; Humans; Pregnancy; Pregnancy Complications, Infectious

2016
Exuberant varicella-zoster exanthema and pneumonia as clinical clue for HIV infection.
    The Journal of pediatrics, 2015, Volume: 166, Issue:1

    Topics: Acyclovir; Anti-Bacterial Agents; Antiviral Agents; CD4 Lymphocyte Count; Chickenpox; Child, Preschool; Clindamycin; Drug Therapy, Combination; Exanthema; Floxacillin; Herpesvirus 3, Human; HIV Infections; HIV-1; Humans; Male; Pneumonia, Viral; Trimethoprim, Sulfamethoxazole Drug Combination

2015
Atypical Varicella in a Patient With Wolf-Hirschhorn Syndrome.
    Clinical pediatrics, 2015, Volume: 54, Issue:11

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child, Preschool; Diagnosis, Differential; Female; Humans; Wolf-Hirschhorn Syndrome

2015
Quiz page April 2015: fever and encephalopathy in a kidney transplant recipient.
    American journal of kidney diseases : the official journal of the National Kidney Foundation, 2015, Volume: 65, Issue:4

    Topics: Acyclovir; Adult; Antiviral Agents; Brain Diseases; Central Nervous System Diseases; Cerebral Arterial Diseases; Chickenpox; Fatal Outcome; Fever; Glomerulonephritis; Herpesvirus 3, Human; Humans; Kidney Transplantation; Magnetic Resonance Imaging; Male

2015
Successful prevention of varicella outbreak in an overcrowded paediatric oncology ward using oral acyclovir prophylaxis.
    Journal of tropical pediatrics, 2015, Volume: 61, Issue:2

    Topics: Acyclovir; Administration, Oral; Antibiotic Prophylaxis; Antineoplastic Agents; Chickenpox; Child; Disease Outbreaks; Hospitals, Teaching; Humans; Immunocompromised Host; India; Infection Control; Neoplasms; Outcome Assessment, Health Care

2015
Failure of a Single Varicella Vaccination to Protect Children With Cancer From Life-Threatening Breakthrough Varicella.
    The Pediatric infectious disease journal, 2015, Volume: 34, Issue:9

    We report 2 children with life-threatening breakthrough varicella. Both had received 1 varicella vaccination before onset of cancer. Despite treatment with intravenous acyclovir, 1 child died of disseminated varicella. Because similar fatal cases have been reported, high-risk immunocompromised children with 1 varicella vaccination may warrant the same varicella prophylaxis as immunocompromised children who have never been vaccinated.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child, Preschool; Fatal Outcome; Female; Humans; Immunization Schedule; Immunocompromised Host; Male; Neoplasms

2015
Varicella at "Casa Garrahan", 2008-2013: Assessment of postexposure prophylaxis measures.
    Archivos argentinos de pediatria, 2015, Volume: 113, Issue:3

    Casa Garrahan (CG) accommodates children with complex conditions referred nationwide; these children are seen in children's hospitals located in the Autonomous City of Buenos Aires. Varicella is a highly-contagious disease, with attack rates of up to 90% among susceptible individuals. In closed communities, the implementation of outbreak control measures is critical.. To describe the characteristics of children exposed to varicella at CG, the implemented prophylaxis measures and their effectiveness.. Prospective, cohort study. Children exposed to varicella at CG between2008 and 2013, their demographic and clinical characteristics, immunization and/or history of varicella, prophylaxis measures, and secondary attack rate were assessed.. N: 107. Fifty-three percent (n: 57) were girls. Their median age was 84 months old [interquartile range (IQR): 24-144]. Ninety-five percent (n: 102) had an underlying disease [hemato-oncological disease: 39% (n: 42); neurological disease: 18% (n: 19); congenital heart disease: 9% (n: 10); and post-operative period: 65 (n: 6)]. Fifty percent had some degree of immunosuppression (n: 54). Twenty-nine percent (n: 31) referred to have had varicella; 27% (n: 29) indicated that they never had the infection; and 41% (n: 44) did not recall a history of varicella. Only 3% (n: 3) had been vaccinated. Based on their immune status, age and history of varicella, acyclovir was indicated as prophylaxis in 61% (n: 65); immunization in 10% (n: 10); and gamma globulin in 1 patient. No adverse effects were observed in relation to the different prophylaxis measures. No secondary cases were observed at 30 days.. Implemented measures were effective to prevent secondary cases. Among healthy and immunocompromised children, prophylaxis with acyclovir was effective and well-tolerated.

    Topics: Acyclovir; Antiviral Agents; Argentina; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Cohort Studies; Female; Hospitals, Pediatric; Humans; Male; Post-Exposure Prophylaxis; Prospective Studies

2015
Use of steroids for management of varicella pneumonia.
    BMJ case reports, 2015, Aug-11, Volume: 2015

    Varicella pneumonia (VP) is a critical complication of varicella infection and still carries significant morbidity and mortality, often requiring intensive care unit admission. Current accepted treatment is with intravenous aciclovir and organ support, if required. We report two cases of VP with acute respiratory failure, successfully treated with intravenous steroids in addition to aciclovir. Further research into the benefits of steroid therapy in VP is warranted.

    Topics: Acyclovir; Administration, Intravenous; Aged; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Humans; Male; Middle Aged; Pneumonia, Viral; Steroids; Treatment Outcome

2015
Extrapolation of Valacyclovir Posology to Children Based on Pharmacokinetic Modeling.
    The Pediatric infectious disease journal, 2015, Volume: 34, Issue:12

    Valacyclovir is a prodrug of acyclovir. Although acyclovir is approved for children in Europe, valacyclovir is not approved, despite being used off-label. The aim of the study was to extrapolate the approved dosages of acyclovir, to valacyclovir dosages, in children using Monte Carlo simulations based on the population pharmacokinetic (PopPK) models of valacyclovir and acyclovir.. Assuming that the recommended dosages of acyclovir are efficacious, a PopPK model of acyclovir was used to perform simulations to determine a critical concentration (Ccrit) for which a target criterion is fulfilled, ie, 90% of the simulated patients have acyclovir levels above Ccrit for at least half the time. The same was done for a secondary target, drug exposure, determining a critical area under the curve in 24 hours at steady state. Then a PopPK model of valacyclovir was used to determine by simulations, dosage regimens that fulfill the criteria for both targets. This was repeated for various indications and age groups.. Indicatively, for the treatment of varicella zoster virus, in ages 2-12 years, Ccrit and critical area under the curve in 24 hours at steady state were found to be 0.39 mg/L and 9.6 mg/L × h, respectively, using the acyclovir approved doses 20 mg/kg 4 times daily. For these breakpoints, a 20 mg/kg, 3 times daily, valacyclovir dose achieves the targets in 97% and 100% of the patients, respectively. We found that some patients receive higher than the ideal doses of acyclovir.. Simulations were used to determine the appropriate doses of valacyclovir in children to support a pediatric investigation plan targeting a paediatric-use marketing authorization application in the European Medicines Agency.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Computer Simulation; Herpesvirus 3, Human; Humans; Infant; Models, Biological; Valacyclovir; Valine

2015
Chest Pain in a 17-Year-Old Girl with Chickenpox.
    Pediatric annals, 2015, Volume: 44, Issue:9

    Topics: Acyclovir; Adolescent; Anti-Arrhythmia Agents; Anti-Inflammatory Agents, Non-Steroidal; Antiviral Agents; Atenolol; Chest Pain; Chickenpox; Diagnosis, Differential; Diclofenac; Female; Heart; Humans; Magnetic Resonance Imaging; Myocarditis; Myocardium

2015
A rare case of ulcerative colitis exacerbated by VZV infection.
    Clinical journal of gastroenterology, 2015, Volume: 8, Issue:6

    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.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Colitis, Ulcerative; Colonoscopy; Gastrointestinal Agents; Glucocorticoids; Humans; Immunocompromised Host; Infliximab; Male; Methylprednisolone; Prednisolone; Recurrence

2015
Fatal varicella due to the vaccine-strain varicella-zoster virus.
    Human vaccines & immunotherapeutics, 2014, Volume: 10, Issue:1

    We describe a death in a 15-mo-old girl who developed a varicella-like rash 20 d after varicella vaccination that lasted for 2 mo despite acyclovir treatment. The rash was confirmed to be due to vaccine-strain varicella-zoster virus (VZV). This is the first case of fatal varicella due to vaccine-strain VZV reported from the United States. The patient developed severe respiratory complications that worsened with each new crop of varicella lesions; vaccine-strain VZV was detected in the bronchial lavage specimen. Sepsis and multi-organ failure led to death. The patient did not have a previously diagnosed primary immune deficiency, but her failure to thrive and repeated hospitalizations early in life (starting at 5 mo) for presumed infections and respiratory compromise treated with corticosteroids were suggestive of a primary or acquired immune deficiency. Providers should monitor for adverse reactions after varicella vaccination. If severe adverse events develop, acyclovir should be administered as soon as possible. The possibility of acyclovir resistance and use of foscarnet should be considered if lesions do not improve after 10 d of treatment (or if they become atypical [e.g., verrucous]). Experience with use of varicella vaccine indicates that the vaccine has an excellent safety profile and that serious adverse events are very rare and mostly described in immunocompromised patients. The benefit of vaccination in preventing severe disease and mortality outweigh the low risk of severe events occurring after vaccination.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Fatal Outcome; Female; Herpesvirus 3, Human; Humans; Infant; Multiple Organ Failure; Sepsis; Treatment Failure; United States

2014
Clinical features and risk factors for developing varicella zoster virus dissemination following hematopoietic stem cell transplantation.
    Transplant infectious disease : an official journal of the Transplantation Society, 2014, Volume: 16, Issue:2

    We retrospectively analyzed 80 instances of varicella zoster virus (VZV) disease in 72 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) and examined the clinical differences between localized and disseminated disease. Risk factors for developing VZV dissemination were also evaluated.. Of the 80 instances, 54 instances were localized diseases and 26 were disseminated diseases. Patient characteristics did not differ significantly between the 2 groups, except for the first-line therapy and the duration from symptom onset to treatment. In the disseminated group, intravenous acyclovir was used as the first-line therapy more frequently, and more time elapsed before beginning antiviral therapy compared with the localized group. In multivariate analyses, the duration from symptom onset to treatment was identified as an independent risk factor that significantly affected the development of VZV dissemination. Gender, total body irradiation, and chronic graft-versus-host disease, of which the latter 2 factors were reported as risk factors for the development of VZV disease after HSCT, did not affect the development of VZV dissemination.. Our results suggest that VZV infection or reactivation may easily progress to viremia with delayed use of antiviral agents and may result in VZV dissemination in immunocompromised patients.

    Topics: Acyclovir; Adolescent; Adult; Aged; Antiviral Agents; Central Nervous System Viral Diseases; Chickenpox; Disease-Free Survival; Female; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Survival Rate; Time-to-Treatment; Valacyclovir; Valine; Virus Activation; Young Adult

2014
Risk factors for complicated varicella infection in pediatric oncology patients at a tertiary health care facility in Pakistan.
    Journal of infection in developing countries, 2014, Feb-13, Volume: 8, Issue:2

    Varicella zoster infection (VZI) is well recognized as a potential cause of morbidity and mortality in immunocompromised pediatric oncology patients (POP). The purpose of this study was to describe the clinical profile and risk factors for complications and outcomes of VZI in POP treated with acyclovir.. Medical records of all POP with a discharge diagnosis of VZI over a period of seven years (2005-2011) were reviewed. The demographic features, underlying malignancy, risk factors for VZI, complications, and outcomes were recorded.. Thirty-six POP with VZI were identified. Leukemia was the most common underlying malignancy (n = 20, 58.8%), followed by lymphoma (n = 7, 20.6%) and solid organ tumors (n = 7, 20.6%). Most of the cases (41%) were observed in children under five. All patients were treated with acyclovir. Varicella-related complications developed in 10 (29%) patients. The most frequent complication was bloodstream infection (n = 3, 8.8%), followed by pneumonia (n = 2, 5.9%), skin infection (n = 2, 5.9%), hepatitis, renal failure, and encephalitis. Independent risk factors associated with complications were age < five years, weight for age < fifth percentile, delay in seeking care (> seven days after onset of symptoms) and severe neutropenia (ANC < 500/cm). One child died secondary to varicella encephalitis.. Our data suggests that young age, poor health-seeking behavior, severe neutropenia, and being underweight are the major risk factors for the development of varicella-related complications in POP in developing countries. These complications could be favorably modified through active immunization of immunocompetent children.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Humans; Immunocompromised Host; Infant; Logistic Models; Neoplasms; Pakistan; Retrospective Studies; Risk Factors; Skin Diseases, Infectious; Tertiary Care Centers

2014
Hemorrhagic varicella in a newborn.
    Indian pediatrics, 2014, Volume: 51, Issue:1

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Skin

2014
Early recovery in post Varicella transverse myelitis.
    Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2014, Volume: 24 Suppl 2

    A 7 years old boy presenting with acute flaccid paralysis after Varicella zoster infection was diagnosed as having acute transverse myelitis on MRI. He recovered fully after treatment with intravenous corticosteroids and acyclovir. The occurrence of this condition during or following Varicella infection is uncommon. There are previously very few reported cases of post-Varicella acute transverse myelitis in which recovery started after 3 months of treatment. In this case complete recovery occurred in 2 weeks of treatment. This report emphasizes the need for Varicella zoster vaccine to prevent not only acute Varicella, but also its rare postinfectious neurologic sequelae.

    Topics: Acute Disease; Acyclovir; Administration, Intravenous; Antiviral Agents; Chickenpox; Child; Glucocorticoids; Herpesvirus 3, Human; Humans; Male; Methylprednisolone; Myelitis, Transverse; Treatment Outcome

2014
[Varicella pneumonia].
    La Revue du praticien, 2014, Volume: 64, Issue:5

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Humans; Male; Pneumonia, Viral; Radiography; Treatment Outcome

2014
β-l-1-[5-(E-2-bromovinyl)-2-(hydroxymethyl)-1,3-(dioxolan-4-yl)] uracil (l-BHDU) prevents varicella-zoster virus replication in a SCID-Hu mouse model and does not interfere with 5-fluorouracil catabolism.
    Antiviral research, 2014, Volume: 110

    The alphaherpesvirus varicella-zoster virus (VZV) causes chickenpox and shingles. Current treatments are acyclovir (ACV) and its derivatives, foscarnet and brivudine (BVdU). Additional antiviral compounds with increased potency and specificity are needed to treat VZV, especially to treat post-herpetic neuralgia. We evaluated β-l-1-[5-(E-2-bromovinyl)-2-(hydroxymethyl)-1,3-(dioxolan-4-yl)] uracil (l-BHDU, 1) and 5'-O-valyl-l-BHDU (2) in three models of VZV replication: primary human foreskin fibroblasts (HFFs), skin organ culture (SOC) and in SCID-Hu mice with skin xenografts. The efficacy of l-BHDU in vivo and its drug-drug interactions were previously not known. In HFFs, 200μM l-BHDU was noncytotoxic over 3days, and l-BHDU treatment reduced VZV genome copy number and cell to cell spread. The EC50 in HFFs for l-BHDU and valyl-l-BHDU were 0.22 and 0.03μM, respectively. However, l-BHDU antagonized the activity of ACV, BVdU and foscarnet in cultured cells. Given its similar structure to BVdU, we asked if l-BHDU, like BVdU, inhibits 5-fluorouracil catabolism. BALB/c mice were treated with 5-FU alone or in combination with l-BHDU or BVdU. l-BHDU did not interfere with 5-FU catabolism. In SCID-Hu mice implanted with human skin xenografts, l-BHDU and valyl-l-BHDU were superior to ACV and valacyclovir. The maximum concentration (Cmax) levels of l-BHDU were determined in mouse and human tissues at 2h after dosing, and comparison of concentration ratios of tissue to plasma indicated saturation of uptake at the highest dose. For the first time, an l-nucleoside analog, l-BHDU, was found to be effective and well tolerated in mice.

    Topics: Acyclovir; Animals; Antiviral Agents; Bromodeoxyuridine; Cell Line; Chickenpox; Dioxolanes; Drug Therapy, Combination; Fluorouracil; Foscarnet; Herpes Zoster; Herpesvirus 3, Human; Humans; Mice; Mice, Inbred BALB C; Mice, SCID; Nucleosides; Organ Culture Techniques; Skin; Uracil; Virus Replication

2014
Relapse of immune thrombocytopenia associated with varicella 20 years after splenectomy.
    Internal medicine (Tokyo, Japan), 2014, Volume: 53, Issue:23

    A 45-year-old man who had undergone splenectomy 20 years earlier for immune thrombocytopenia (ITP) presented with a fever, arthralgia and vesicular skin rash. The skin rash was typical for varicella, as confirmed on serological studies. He exhibited isolated thrombocytopenia and was diagnosed with ITP. In addition, an accessory spleen was detected. The platelet count responded to treatment with prednisolone (PSL), and the varicella subsided uneventfully following therapy with acyclovir. Furthermore, the platelet count was maintained after PSL was discontinued. This case suggests an etiological link between varicella and very late relapse of ITP after initial splenectomy.

    Topics: Acyclovir; Antiviral Agents; Arthralgia; Chickenpox; Chronic Disease; Fever; Humans; Male; Middle Aged; Platelet Count; Prednisolone; Purpura, Thrombocytopenic, Idiopathic; Recurrence; Splenectomy; Time Factors; Treatment Outcome

2014
Should all adults with varicella be prescribed antiviral treatment?
    The Medical journal of Australia, 2013, Mar-18, Volume: 198, Issue:5

    Topics: Acyclovir; Adolescent; Adult; Age Factors; Antiviral Agents; Australia; Chickenpox; Chickenpox Vaccine; Communicable Disease Control; Drug Utilization Review; Female; General Practice; Health Care Costs; Humans; Male; Practice Patterns, Physicians'; Prescriptions; Risk Assessment; Severity of Illness Index; Vaccination; Young Adult

2013
Varicella death of an unvaccinated, previously healthy adolescent--Ohio, 2009.
    MMWR. Morbidity and mortality weekly report, 2013, Apr-12, Volume: 62, Issue:14

    Varicella usually is a self-limited disease but sometimes can result in severe complications and death. Although infants, adults, and immunocompromised persons are at increased risk for severe disease, before varicella vaccine was introduced in 1995, the majority of hospitalizations and deaths from varicella occurred among healthy persons aged <20 years. Introduction of varicella vaccine has substantially decreased varicella incidence, hospitalizations, and deaths in the United States. This report describes a varicella death in an unvaccinated, previously healthy adolescent aged 15 years. In April 2012, as part of the routine review of vital statistics records, the Ohio Department of Health identified a 2009 death with the International Classification of Diseases, 10th Revision code for varicella as the underlying cause. Because varicella deaths are nationally reportable, the Ohio Department of Health conducted an investigation to validate that the coding was accurate. Investigators learned that, on March 12, 2009, the adolescent girl was admitted to a hospital with a 3-day history of a rash consistent with varicella and a 1-day history of fever and shortness of breath. The patient was started on intravenous acyclovir (on day 4 of illness) and broad-spectrum antibiotics and antifungals, but she died 3 weeks later. The case underscores the importance of varicella vaccination, including catch-up vaccination of older children and adolescents, to prevent varicella and its serious complications.

    Topics: Acyclovir; Adolescent; Anti-Bacterial Agents; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Fatal Outcome; Female; Humans; International Classification of Diseases; Lung; Ohio; Pneumonia; Respiratory Distress Syndrome; Sepsis

2013
Varicella pneumonia in an immunocompetent adult.
    Respiration; international review of thoracic diseases, 2013, Volume: 86, Issue:1

    Topics: Acyclovir; Administration, Intravenous; Adult; Antiviral Agents; Chickenpox; Glucocorticoids; Humans; Male; Methylprednisolone; Pneumonia, Viral; Smoking

2013
Neonatal varicella infection: are we being falsely reassured by a maternal history of chickenpox?
    British journal of hospital medicine (London, England : 2005), 2013, Volume: 74, Issue:6

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Herpesvirus 3, Human; Humans; Infant, Newborn; Male; Polymerase Chain Reaction; Time Factors

2013
Varicella gastritis in an immunocompetent child.
    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2013, Volume: 56, Issue:2

    The varicella zoster virus (VZV) is a very rare cause of gastritis. Gastritis caused by VZV can be presented as abdominal pain, vomiting. Most of the cases reported with varicella gastritis in the literature are immunocompromised patients with various kinds of malignancy, and most of these patients are adults. Here we report an adolescent girl with acute abdominal pain. The girl was immunocompetent. Her endoscopically taken biopsy material revealed varicella, and her gastritis was healed with acyclovir therapy. This is a very rare condition and not frequently reported in the literature. The authors want to drive attention to the fact that varicella gastritis can be seen in immunocompetent children, the presentation can be nausea, vomiting and/or (severe) abdominal pain. Serological studies may be less helpful than tissue studies, so interventional procedures should be done.

    Topics: Abdominal Pain; Acyclovir; Adolescent; Antiviral Agents; Biopsy; Chickenpox; Female; Gastritis; Gastroscopy; Herpesvirus 3, Human; Humans; Treatment Outcome

2013
Acne-like presentation of recurrent varicella infection in a child with nephrotic syndrome.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2012, Volume: 95 Suppl 12

    Primary infection with varicella zoster virus was assumed to confer lifelong immunity. Nevertheless, cases of varicella reinfection had been reported regardless of immune status. Here the authors described a case of 11-year old girl with nephrotic syndrome, currently on 80 milligrams of prednisolone for one month. She presented with one day of fever, diarrhea and acne-like rash at her forehead, nose and few on the neck. She had a past history of chickenpox. Her vesicles were examined by pediatric dermatologist and Tzanck smear was performed. Multinucleated giant cells were detected and diagnosis of varicella was made. This report infers that positive varicella history alone might not be sufficient to confer immunity, especially in immunocompromised host. Atypical presentation of recurrent varicella in immunocompromised host can be presented.

    Topics: Acne Vulgaris; Acyclovir; Antiviral Agents; Chickenpox; Child; Diagnosis, Differential; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Nephrotic Syndrome; Prednisolone; Recurrence

2012
Acute pancreatitis : complication of chicken pox in an immunocompetent host.
    The Journal of the Association of Physicians of India, 2012, Volume: 60

    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.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Humans; Immunocompetence; Male; Pancreatitis; Young Adult

2012
Bilateral brachial neuritis secondary to varicella reactivation in an HIV-positive man.
    International journal of STD & AIDS, 2012, Volume: 23, Issue:2

    We present the case of a 48-year-old HIV-positive man, who developed acute onset of pain in both upper limbs associated with proximal weakness and distal paraesthesia. Eight weeks prior to this presentation he had had varicella zoster affecting his right S1 dermatome. CD4 count was 355 cells/mm(3) and he was antiretroviral therapy (ART) naive. Power was 0/5 proximally and 4/5 distally in the upper limbs. Reflexes were absent and there was sensory loss in the C5, C6 and T1 dermatomes. Cerebrospinal fluid (CSF) examination showed a lymphocytosis with low glucose; however, CSF Mycobacterium tuberculosis (TB), and herpes simplex virus polymerase chain reaction (HSV PCR) were negative as was syphilis serology. Electromyography showed marked motor axonal loss. Magnetic resonance imaging (MRI) did not show any cervical spinal lesion. Varicella zoster virus (VZV) PCR was positive in the CSF. He was treated with high-dose intravenous aciclovir with good resolution of his syndrome over time and was commenced on ART. We believe this to be the first case report of varicella reactivation causing bilateral neuralgic amyotrophy in an HIV-positive patient.

    Topics: Acyclovir; Antiviral Agents; Brachial Plexus Neuritis; Chickenpox; Herpesvirus 3, Human; HIV Infections; Humans; Male; Middle Aged; Virus Activation

2012
Varicella pneumonitis.
    Internal medicine (Tokyo, Japan), 2012, Volume: 51, Issue:6

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Incidental Findings; Pneumonia, Viral; Radiography

2012
Acute urinary retention as a complication of primary varicella-zoster infection of childhood - a second reported case.
    South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2012, Mar-14, Volume: 102, Issue:4

    Topics: Acute Disease; Acyclovir; Antiviral Agents; Chickenpox; Child; Constipation; Herpesvirus 3, Human; Humans; Laxatives; Male; Urinary Catheterization; Urinary Retention

2012
Varicella zoster virus disease after pediatric living donor liver transplantation: is it serious?
    Transplantation proceedings, 2012, Volume: 44, Issue:3

    The aim of this study was to evaluate patients who developed varicella zoster virus (VZV) disease after pediatric living donor liver transplantation (PLDLT).. Two hundred fifty-five patients who underwent PLDLT between 1995 and 2010 were included in this study. Pretransplantation vaccination of VZV was performed for all recipients except emergency PLDLTs. Posttransplantation VZV vaccination was administered to the patients with a low VZV antibody titer 2 years or more after transplantation. The clinical course and outcomes of VZV disease in cases were reviewed with the transplant database and hospital medical records.. Sixty-three patients developed VZV disease (chicken pox in 61, herpes zoster in 2) at a median onset of 36 months after PLDLT and at a median age of 4 years old, with a cumulative incidence of 25%. All chicken pox occurred in VZV antibody-negative patients. The onset of herpes zoster in the two patients occurred within 3 months after PLDLT; in addition, these patients were VZV antibody-positive patients. The clinical presentations of most patients were not serious and there were no disseminated infections. Although only 3 patients (5%) were hospitalized, the other 60 patients (95%) all showed a good response to oral antiviral therapy.. Although VZV disease is an infectious disease with a high morbidity rate after PLDLT, it can normally be successfully managed on an outpatient basis at home. Pre- and posttransplantation vaccinations are effective for delaying the onset of chicken pox after PLDLT and to prevent it from developing into a serious illness.

    Topics: Acyclovir; Antibodies, Viral; Antiviral Agents; Chickenpox; Child; Herpesvirus 3, Human; Humans; Immunoenzyme Techniques; Liver Transplantation; Living Donors

2012
Varicella pneumonia in an immunocompetent adult.
    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2012, Nov-20, Volume: 184, Issue:17

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Immunocompetence; Pneumonia, Viral

2012
Acute liver failure due to Varicella zoster virus infection after lung transplantation: a case report.
    Transplantation proceedings, 2012, Volume: 44, Issue:5

    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.

    Topics: Acyclovir; Adult; Antiviral Agents; Bronchiectasis; Chickenpox; Fatal Outcome; Herpesvirus 3, Human; Humans; Liver Failure, Acute; Liver Transplantation; Lung Transplantation; Male; Multiple Organ Failure; Respiratory Insufficiency; Time Factors; Waiting Lists

2012
A 12-day-old male newborn with extensive vesicles and fever.
    BMJ case reports, 2012, Jan-18, Volume: 2012

    Neonatal varicella infection is a rare condition since vaccine introduction. The authors report the case of a 12-day-old male who presented with a fever and generalised vesicular eruption. The patient's mother had varicella infection 1 day before delivery without treatment. The neonate initially did not receive prophylaxis or treatment. He subsequently was started on intravenous acyclovir and recovered without further complications or sequelae. Prompt diagnosis and treatment for maternal prenatal varicella infection is necessary to prevent infection in the newborn, and healthcare provider awareness to avoid nosocomial transmission.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Female; Fever; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infectious Disease Transmission, Vertical; Male; Pregnancy; Pregnancy Complications, Infectious

2012
Varicella-zoster virus (VZV) and alpha 1 antitrypsin: a fatal outcome in a patient affected by endemic pemphigus foliaceus.
    International journal of dermatology, 2012, Volume: 51, Issue:7

    Herpes virus infections are well known infectious complications of pemphigus and bullous pemphigoid. We describe pathologic findings utilizing autopsy tissue from several organs from a patient affected by a new variant of endemic pemphigus in El Bagre, Colombia, South America.. We describe a patient by a new variant of endemic pemphigus foliaceus from El Bagre that was receiving high-dosage immunosuppressants when hospitalized and died suddenly following contact with a second patient affected by chicken pox.. We performed studies utilizing hematoxylin and eosin, immunohistochemistry, and direct immunofluorescence techniques on tissues from several organs.. We detected the presence of varicella zoster virus, as well as strong positivity for α-1 antitrypsin in the heart, kidneys, spleen, liver, skin, brain, lungs, pancreas, small and large intestines, and skeletal muscle. In regard to structural damage in the kidney and heart, we believe the observed damage is associated with the presence of autoantibodies to these organs, since both of them are rich in plakins and El Bagre-EPF patients present significant antibodies to plakin molecules.. In patients with endemic pemphigus foliaceus, we recommend complete isolation of the patient when receiving high dosages of systemic immunosuppressive agents. We further suggest the clinical possibility of a synergistic, fatal interaction between active pemphigus foliaceus, varicella zoster virus, herpes simplex virus, immunosuppressive agents, and a systemic activation of α-1 antitrypsin. Thus, we suggest adequate bed spacing, barrier nursing, and preventative testing for α-1 antitrypsin activation are warranted in these patients to address these complications.

    Topics: Acyclovir; Adult; alpha 1-Antitrypsin; Antiviral Agents; Azathioprine; Chickenpox; Endemic Diseases; Fatal Outcome; Herpesvirus 3, Human; Humans; Immunosuppressive Agents; Male; Pemphigus; Prednisone

2012
Varicella infection in a neonate with subsequent staphylococcal scalded skin syndrome and fatal shock.
    BMJ case reports, 2012, Aug-01, Volume: 2012

    A male term neonate, at day 23 of life, presented with vesicular lesions over the trunk, which spread to allover the body on the next day. Five days later, he started developing blistering of the skin over the trunk and extremities, which subsequently ruptured, leaving erythematous, tender raw areas with peeling of the skin. The mother had vesicular eruptions, which started on the second day of delivery and progressed over the next 3 days. Subsequently, similar eruptions were noticed in two of the siblings before affecting the neonate. On the basis of the exposure history and clinical picture, a diagnosis was made of varicella infection with staphylococcal scalded skin syndrome (SSSS). The blood culture and the wound surface culture grew Staphylococcus aureus. Treatment included intravenous fluid, antibiotics, acyclovir and wound care. However, after 72 h of hospitalisation, the neonate first developed shock, refractory to fluid boluses, vasopressors and catecholamine along with other supports; and he then succumbed. In all neonates, staphylococcal infection with varicella can be fatal due to SSSS, the toxic shock syndrome or septicaemia.

    Topics: Acyclovir; Adult; Anti-Bacterial Agents; Antiviral Agents; Chickenpox; Fatal Outcome; Female; Humans; Infant; Infant, Newborn; Male; Mothers; Shock, Septic; Skin; Staphylococcal Scalded Skin Syndrome; Staphylococcus aureus

2012
A case of internal ophthalmoplegia associated with varicella zoster.
    Journal of pediatric ophthalmology and strabismus, 2012, Aug-07, Volume: 49 Online

    The authors report a case of internal ophthalmoplegia in a 5-year-old boy presenting after primary varicella infection. This is an uncommon and mostly irreversible ocular manifestation after chickenpox. The internal ophthalmoplegia showed a potential mild improvement with oral acyclovir. Consideration should be given to starting treatment on presentation in such cases.

    Topics: Acyclovir; Administration, Oral; Antiviral Agents; Chickenpox; Child, Preschool; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Male; Ophthalmoplegia; Visual Acuity

2012
Therapeutic approach to chickenpox in children and adults--our experience.
    Medical archives (Sarajevo, Bosnia and Herzegovina), 2012, Volume: 66, Issue:3 Suppl 1

    Chickenpox is highly contagious childhood disease which occurs as a result of varicella-zoster virus primary infection. Symptomatic therapy is usually adequate for chickenpox, but in some cases it requires combinations of antiviral drugs and antibiotics.. To present our expirience with chickenpox therapy in children and adult patients.. Study included 120 randomly chosen patients, 60 adults and 60 children, with confirmed chickenpox infection, hospitalised at Clinic for infectious diseases in Sarajevo. Observed period was 1st January 2005. to 30th June 2011. We compared used therapy and outcome of disease.. We had 333 patients with confirmed chickenpox in mentioned period. Male sex prevailed. Antiviral (acyclovir) therapy was initiated in 8(13.5%) adults and 16(27%) children. Most frequently used antibiotic was Co-Amoxiclav in a group of adults and Ceftriaxone in a group of children.. We use different terapeutical approaches to chickenpox according to the severity of the clinical picture and the existence of underlying diseases. Symptomatic treatment is indicated in all immunocompetent patients with no signs of complications. Use of corticosteroids remains open dillemma. Our therapeutical approcach followed by actual guidelines proved to be usefull. No death cases were recorded in these

    Topics: Acyclovir; Adolescent; Adult; Anti-Bacterial Agents; Chickenpox; Child; Child, Preschool; Drug Therapy, Combination; Female; Humans; Infant; Male; Middle Aged; Young Adult

2012
[Varicella pneumonia of the newborn: a case about].
    The Pan African medical journal, 2012, Volume: 13

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Diagnosis, Differential; Female; Humans; Infant, Newborn; Male; Placenta; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious

2012
Concomitant use of acyclovir and intravenous immunoglobulin rescues an immunocompromised child with disseminated varicella caused multiple organ failure.
    Journal of pediatric hematology/oncology, 2011, Volume: 33, Issue:8

    Varicella is a common and mild disease in healthy children. However, when patients are in immunocompromised conditions, such as receiving chemotherapy for cancer treatment, they are highly vulnerable and it can even prove lethal. Herein, we report a 14-year-old boy with acute lymphoblastic leukemia who was receiving chemotherapy for induction with vincristine, idarubicin, L-asparaginase, and prednisolone, presented with typical varicella skin lesions and varicella-zoster virus was detected in his serum by real-time polymerase chain reaction (PCR). His condition was advanced to multiple organs failure, including fulminant hepatitis, disseminated intravascular coagulation, and myocarditis despite acyclovir administration. After a combined therapy with intravenous acyclovir and high-dose intravenous immunoglobulin, his condition was dramatically improved. We suggest that IVIG may be used immediately with acyclovir when immunocompromised patients with varicella advanced to dissemination are identified.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Combined Modality Therapy; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Male; Multiple Organ Failure; Precursor Cell Lymphoblastic Leukemia-Lymphoma

2011
Varicella outbreak in Indian students in Magdeburg with detection of the African-Indian VZV clade 5.
    Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2011, Volume: 9, Issue:6

    Varicella has the highest contagiosity index of all viral diseases. We report an endemic outbreak of varicella among 4 Indian students in Magdeburg in November and December 2008. An initially severe course was observed in three of these patients with a negative vaccination status. Large vesicular skin lesions with a diameter of up to 8 mm were found in all patients. Molecular genetic tests revealed African/Indian clade 5 in 2 patients, although the European clades (i.e., clade 1 and 3) are the most common in Germany, accounting for 85 %. All patients recovered without any complications after administration of intravenous aciclovir at a dosage of 10 mg per kg body weight. Although isolated cases of varicella are not notifiable according to the German Protection against Infection Act, endemic outbreaks must be reported to the appropriate health surveillance authorities.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Disease Outbreaks; Emigration and Immigration; Germany; Herpesvirus 3, Human; Humans; India; Treatment Outcome

2011
Nosocomial transmission of varicella to a healthcare provider positive for anti-varicella zoster virus antibodies: nonprotective positivity with an immune adherence hemagglutination assay.
    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2011, Volume: 17, Issue:5

    A 24-year-old male healthcare provider, having attended a varicella patient 2 weeks before, developed varicella himself. He had shown a positive result for anti-VZV antibodies measured with an immune adherence hemagglutination assay (1:4) 1 year before. The present case shows that a positive result with this assay does not necessarily indicate protection against VZV infection.

    Topics: Acyclovir; Adult; Antibodies, Viral; Chickenpox; Cross Infection; Hemagglutination Tests; Herpesvirus 3, Human; Humans; Immune Adherence Reaction; Immunoglobulin G; Immunoglobulin M; Infectious Disease Transmission, Patient-to-Professional; Male; Valacyclovir; Valine

2011
Varicella-zoster virus infections in immunocompromised patients - a single centre 6-years analysis.
    BMC pediatrics, 2011, May-10, Volume: 11

    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.. 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.. 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.. 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.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Child, Preschool; Cidofovir; Cytosine; Female; Herpes Zoster; Herpesvirus 3, Human; Hospitalization; Humans; Immunocompromised Host; Incidence; Infant; Male; Organophosphonates; Practice Guidelines as Topic

2011
PEPtalk: postexposure prophylaxis against varicella in children with cancer.
    Archives of disease in childhood, 2011, Volume: 96, Issue:9

    To describe postexposure prophylaxis (PEP) against varicella zoster virus (VZV) in children being treated for malignancy in the UK and Ireland: the population at risk, frequency of exposure, clinical practice and attitudes among healthcare providers.. An observational study in three parts: (1) a retrospective survey of serostatus at diagnosis of malignancy, (2) collation of varicella zoster immune globulin (VZIG) dispensing data over a 3-year period and (3) an online survey of paediatric oncologists' clinical practice and beliefs in relation to VZV disease and its prevention.. UK and Ireland.. Children diagnosed with malignancy in 2009 (serostatus survey) or receiving VZIG between April 2006 and March 2009 (VZIG dispensing study). Paediatric oncologists and haematologists working in tertiary paediatric oncology centres and related shared care units in the UK and Ireland (physician survey).. Of 1500 children diagnosed with malignancy each year, at least 24% are VZV seronegative. Few centres make efforts to prevent household exposure by vaccinating VZV-susceptible family members. Exposures to VZV result in the administration of PEP to approximately 250 children with cancer annually: half receive an intramuscular injection of VZIG while the remainder receive a course of oral aciclovir. The choice of PEP is made by doctors. There is no consensus among paediatric oncologists as to which is the better option, reflecting the lack of a secure evidence base.. A randomised controlled trial to compare the effectiveness and acceptability of VZIG and aciclovir as PEP against varicella is both desirable and feasible.

    Topics: Acyclovir; Antibodies, Viral; Antiviral Agents; Attitude of Health Personnel; Chickenpox; Child; Child, Preschool; Drug Utilization; Epidemiologic Methods; Herpesvirus 3, Human; Humans; Immune Sera; Neoplasms; Opportunistic Infections; Post-Exposure Prophylaxis; Professional Practice; Randomized Controlled Trials as Topic

2011
Rash in a neonate.
    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2011, Volume: 52, Issue:4

    Topics: Acyclovir; Antibodies, Viral; Antiviral Agents; Chickenpox; Exanthema; Female; Herpesvirus 3, Human; Humans; Infant, Newborn; Polymerase Chain Reaction

2011
[Varicella pneumonia requiring invasive mechanical ventilation].
    Tuberkuloz ve toraks, 2011, Volume: 59, Issue:3

    We aimed to report a case of varicella pneumonia that resulted in respiratory failure requiring mechanical ventilation. The patient was a 40-year-old man whose rashes started after his childeren developed varicella and who had a high fever, sputum and sputum with blood, cough, cold and shiver four days before admission. A treatment was commenced by an antiviral acyclovir and ampiric ampicillin-sulbactam therapy. Although a supporting oxygen treatment, the patient whose oxygen saturation did not increase and respiratory rate was high was commenced by an invasive mechanical ventilation because of a respiratory failure. The patient that had a recovery in clinical symptoms after 36 hours was extubated and was discharged from hospital by the following week.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Humans; Male; Pneumonia, Viral; Respiration, Artificial; Respiratory Insufficiency; Treatment Outcome

2011
Rash and dyspnoea in a 39 year old man.
    BMJ (Clinical research ed.), 2011, Dec-29, Volume: 343

    Topics: Acyclovir; Adult; Antiviral Agents; Bangladesh; Chickenpox; Diagnosis, Differential; Disease Transmission, Infectious; Dyspnea; Exanthema; Humans; Lung; Male; Pneumonia, Viral; Pruritus; Radiography

2011
[Chickenpox case estimation in acyclovir pharmacy survey and early bioterrorism detection].
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 2011, Volume: 85, Issue:6

    Early potential health hazards and bioterrorism threats require early detection. Smallpox cases caused by terrorist could, for example, be treated by prescribing acyclovir to those having fever and vesicle exanthema diagnosed as chicken pox. We have constructed real-time pharmacy surveillance scenarios using information technology (IT) to monitor acyclovir prescription.. We collected the number of acyclovir prescriptions from 5138 pharmacies using the Application Server Provider System (ASP) to estimate the number of cases. We then compared the number of those given acyclovir under 15 years old from pharmacy surveillance and sentinel surveillance for chickenpox under the Infection Disease Control Law.. The estimated number of under 15 years old prescribed acyclovir in pharmacy surveillance resembled sentinel surveillance results and showed a similar seasonal chickenpox pattern. The correlation coefficient was 0.8575. The estimated numbers of adults, older than 15 but under 65 years old, and elderly, older than 65, prescribed acyclovir showed no clear seasonal pattern.. Pharmacy surveillance for acyclovir identified the baseline and can be used to detect unusual chickenpox outbreak. Bioterrorism attack could potentially be detected using smallpox virus when acyclovir prescription for adults suddenly increases without outbreaks in children or the elderly. This acyclovir prescription monitoring such as an application is, to our knowledge, the first of its kind anywhre.

    Topics: Acyclovir; Adolescent; Adult; Aged; Antiviral Agents; Bioterrorism; Chickenpox; Data Collection; Drug Utilization; Humans; Middle Aged; Prescriptions; Seasons

2011
Severe meningoencephalitis due to late reactivation of Varicella-Zoster virus in an immunocompetent child.
    Journal of child neurology, 2010, Volume: 25, Issue:1

    Recurrent reactivation of latent Varicella-Zoster virus may cause various neurological complications including encephalitis, myelitis, stroke episodes, and meningitis. It occurs mainly in elderly or immunocompromised patients and is very rare in children. We report a 14-year girl who presented with meningoencephalitis due to reactivation of Varicella-Zoster virus 10 years after she had chickenpox and 4 years after she had zoster. Characteristic skin lesions of varicella were absent. Varicella-Zoster virus DNA was detected in cerebrospinal fluid and magnetic resonance imaging (MRI) findings were consistent with small vessel cerebral vasculitis. Treatment with acyclovir and high dose methylprednisolone resulted in near-complete neurological recovery. Although rare, Varicella-Zoster virus may reactivate to cause significant central nervous system disease even in immunocompetent children. Diagnosis depends on a high degree of suspicion because the typical rash may not associate the disease. Characteristic lesions on MRI and the presence of Varicella-Zoster virus DNA in cerebrospinal fluid are key findings for the correct diagnosis.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Brain; Chickenpox; Diagnosis, Differential; DNA, Viral; Encephalitis, Varicella Zoster; Female; Follow-Up Studies; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompetence; Meningoencephalitis; Methylprednisolone; Time Factors; Treatment Outcome; Vasculitis, Central Nervous System; Virus Activation

2010
Congenital varicella syndrome/vericella zoster virus (VZV) fetopathy.
    Indian journal of pediatrics, 2010, Volume: 77, Issue:1

    An 18 hour old female newborn born to a 3rd gravida HIV -ve mother, presented with a large erythematous patch of skin on right forehead and hazy right eye since birth. There was history of Chicken pox in mother during fourteenth week of pregnancy.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Herpesvirus 3, Human; Humans; Infant, Newborn

2010
Acute kidney injury in a child with MCNS during cyclosporine A and acyclovir treatment.
    Clinical and experimental nephrology, 2010, Volume: 14, Issue:6

    Topics: Acute Kidney Injury; Acyclovir; Chickenpox; Child, Preschool; Cyclosporine; Female; Humans; Nephrosis, Lipoid

2010
Post varicella angiopathy.
    The Journal of the Association of Physicians of India, 2010, Volume: 58

    Varicella zoster vasculopathy is a rare complication of chicken pox. Varicella cerebellitis, a post or para-infectious condition, is a common sequelae of chicken pox. Varicella angiopathy presents as acute hemiparesis, aphasia, hemianaesthesia or other focal neurologic or retinal deficits associated with mononuclear pleocytosis and VZV specific antibodies in CSF. Varicella angiopathy affecting the posterior circulation is very rare. We report a 15 yr old boy with progressive neurologic deficits over a month following a chicken pox 3 months prior to the onset of symptoms. On investigation he had infarcts both in the anterior and posterior circulation territories in CT and MRI with mononuclear pleocytosis in CSF elevated IgG and IgM in CSF. He was treated with intravenous acyclovir and corticosteroids.

    Topics: Acyclovir; Adolescent; Adrenal Cortex Hormones; Brain Infarction; Chickenpox; Herpesvirus 3, Human; Humans; Immunoglobulin G; Immunoglobulin M; Leukocytosis; Magnetic Resonance Imaging; Male; Tomography, X-Ray Computed; Treatment Outcome

2010
A patient with bilateral facial palsy associated with hypertension and chickenpox: learning points.
    BMJ case reports, 2010, Nov-26, Volume: 2010

    Bilateral facial nerve paralysis is an uncommon presentation and even more so in children. There are reports of different causes of bilateral facial nerve palsy. It is well-established that hypertension and chickenpox causes unilateral facial paralysis and the importance of checking the blood pressure in children with facial nerve paralysis cannot be stressed enough. The authors report a boy with bilateral facial nerve paralysis in association with hypertension and having recently recovered from chickenpox. The authors review aspects of bilateral facial nerve paralysis as well as hypertension and chickenpox causing facial nerve paralysis.

    Topics: Acyclovir; Antihypertensive Agents; Antiviral Agents; Chickenpox; Child; Cooperative Behavior; Diagnosis, Differential; Facial Paralysis; Follow-Up Studies; Headache; Humans; Hypertension, Renal; Interdisciplinary Communication; Losartan; Male; Neurologic Examination; Valacyclovir; Valine

2010
Bilateral middle cerebral artery infarctions following mild varicella infection: a case report.
    Brain & development, 2009, Volume: 31, Issue:1

    We report a two-year and one-month-old immunocompetent boy who developed aphasia and right hemiparesis eight months after mild varicella with only a few vesicles. Magnetic resonance images and angiography demonstrated mixed acute and old infarctions of the bilateral middle cerebral arteries. VZV-DNA was detected on polymerase chain reaction analysis of cerebral spinal fluid (CSF). He was treated with intravenous acyclovir and edaravone, and his speech and motor functions had almost recovered after two months. Cerebral lesions of the bilateral middle cerebral artery territories and virus DNA detection from CSF are rare in VZV-related vasculopathy and suggest incomplete immunoresponse to varicella in this patient.

    Topics: Acyclovir; Antipyrine; Antiviral Agents; Chickenpox; Child, Preschool; DNA, Viral; Edaravone; Herpesvirus 3, Human; Humans; Infarction, Middle Cerebral Artery; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Polymerase Chain Reaction; Treatment Outcome

2009
Disseminated varicella presenting as acute abdominal pain nine days before the appearance of the rash.
    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2009, Volume: 13, Issue:3

    We report a patient presenting with severe epigastric pain and diffuse abdominal tenderness, with negative imaging and endoscopic evaluation. During hospitalization, the patient developed confusion, seizures, pneumonia, anemia and thrombocytopenia. A hemorrhagic rash appeared on day nine of admission, with serology and skin biopsy confirming a diagnosis of hemorrhagic varicella.

    Topics: Abdominal Pain; Acyclovir; Antiviral Agents; Chickenpox; Confusion; Exanthema; Female; Hemorrhage; Humans; Leukemia, Myeloid, Acute; Middle Aged

2009
Varicella reactivation presenting as shingles and aseptic meningitis in an immunocompetent 11-year-old boy.
    Clinical pediatrics, 2009, Volume: 48, Issue:4

    Topics: Acyclovir; Anti-Bacterial Agents; Antibodies, Viral; Antiviral Agents; Cefotaxime; Chickenpox; Child; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Meningitis, Aseptic; Polymerase Chain Reaction; Recurrence; Spinal Puncture; Vancomycin

2009
The hidden cost of varicella.
    The Medical journal of Australia, 2009, Feb-16, Volume: 190, Issue:4

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Cost of Illness; Female; Humans; Infant; Infectious Disease Transmission, Vertical; Male; Pregnancy; Valacyclovir; Valine

2009
Varicella zoster exposure on paediatric wards between 2000 and 2007: safe and effective post-exposure prophylaxis with oral aciclovir.
    The Journal of hospital infection, 2009, Volume: 72, Issue:2

    Varicella zoster virus is highly contagious and can cause serious complications in immunocompromised patients. To prevent people exposed to the virus from developing secondary varicella we have used oral aciclovir as post-exposure prophylaxis (PEP) since 2000. Between 2000 and 2007, there were 11 unexpected occurrences of varicella and 11 unexpected occurrences of zoster in our paediatric wards. There were 174 contacts, 131 exposed to varicella and 43 exposed to zoster. A total of 163 (94%) received PEP and 11 (6%) did not. The rates of secondary infection among contacts given prophylaxis with aciclovir only were 2.1% (3/141) for all contacts and 1.3% (1/76) for immunocompetent contacts. The rate of secondary infection among contacts not given PEP was significantly higher (18%, 2/11) (P<0.05). No adverse events due to PEP were reported. We conclude that oral aciclovir PEP following exposure to VZV on paediatric wards is both safe and effective.

    Topics: Acyclovir; Administration, Oral; Chemoprevention; Chickenpox; Cross Infection; Herpes Zoster; Humans; Infant

2009
Incidence and risk of postherpetic neuralgia after varicella zoster virus infection in hematopoietic cell transplantation recipients: Hokkaido Hematology Study Group.
    Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2009, Volume: 15, Issue:6

    To assess the incidence of and risk factors associated with postherpetic neuralgia (PHN) after hematopoietic cell transplantation (HCT) varicella zoster virus (VZV) infection, we conducted a retrospective chart review of 418 consecutive patients who underwent HCT between April 2005 and March 2007. The male/female ratio was 221/197, median age at HCT was 47 years (range: 0-69 years), and autologous/allogeneic/syngeneic HCT ratio was 154/263/1. Seventy-eight patients developed VZV infection after HCT. Sixty-two patients had localized zoster, 11 patients had disseminated zoster (rash like chicken pox), and 4 patients had visceral zoster. All cases were treated with acyclovir (ACV) or valacyclovir (VACV), and there was no VZV infection-related death. Twenty-seven (35%) of the 78 patients with VZV infection suffered PHN after resolution of VZV infection. Multivariate analysis showed that advanced age is the only risk factor in autologous HCT (P = .0075; odds ratio [OR] = 1.14; 95% confidence interval [CI], 0.97-1.33). On the other hand, advanced age (P = .0097; OR = 1.06; 95% CI, 1.01-1.12), male gender (P = .0055; OR = 12.7; 95% CI, 1.61-100.1), and graft-versus-host disease (GVHD) prophylaxis with a tacrolimus-based regimen (P = .0092; OR = 9.56; 95% CI, 1.44-63.3) were associated with increased risk of PHN in allogeneic HCT. This study for the first time clarified the risk of PHN in HCT recipients.

    Topics: Acyclovir; Adolescent; Adult; Aged; Chickenpox; Child; Child, Preschool; Female; Genetic Diseases, Inborn; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Humans; Incidence; Infant; Infant, Newborn; Japan; Male; Middle Aged; Neoplasms; Neuralgia, Postherpetic; Postoperative Complications; Retrospective Studies; Risk; Transplantation, Autologous; Transplantation, Homologous; Valacyclovir; Valine; Virus Activation; Young Adult

2009
Varicella pneumonia in southern Israel: clinical characteristics, diagnosis and therapeutic considerations.
    The Israel Medical Association journal : IMAJ, 2009, Volume: 11, Issue:5

    The most common and most serious complication of varicella (chickenpox) in adults is pneumonia, which can lead to severe respiratory failure. Varicella pneumonia is associated with considerable morbidity and even death.. To summarize our experience with varicella pneumonia in terms of clinical, laboratory and radiological characteristics as well as risk factors, management and outcome.. We conducted a retrospective cohort survey in our facility from 1995 to 2008.. Our cohort comprised 21 patients with varicella pneumonia, of whom 19 (90%) were men; their mean age was 35 +/- 10.5 years. Nineteen patients (90%) were Bedouins and 18 (86%) were smokers. Eleven (52%) were admitted to the Medical Intensive Care Unit; 3 of them required mechanical ventilation and the remaining 10 (48%) were admitted to the general medical ward. Median length of stay was 6 +/- 7.7 days. Hypoxemia and elevated lactate dehydrogenase on admission were associated with respiratory failure. Radiological manifestations were variable and nine patients exhibited characteristic findings. All but one patient were treated with acyclovir. All patients fully recovered.. In southern Israel varicella pneumonia is primarily a disease ofyoung male Bedouins who are smokers. Severity ranges from mild disease to severe, resulting at times in respiratory failure requiring mechanical ventilation. Prognosis is favorable with complete recovery.

    Topics: Acyclovir; Adolescent; Adult; Aged; Antiviral Agents; Chickenpox; Female; Herpesvirus 3, Human; Humans; Israel; Male; Middle Aged; Pneumonia, Viral; Respiration, Artificial; Retrospective Studies; Smoking; Young Adult

2009
[Herpes zoster-associated morbidity in children undergoing chemotherapy for acute lymphoblastic leukaemia].
    Ugeskrift for laeger, 2009, Nov-09, Volume: 171, Issue:46

    Herpes zoster rarely occurs in healthy children, but may occur frequently and may take a complicated course in children receiving chemotherapy. We aimed to assess morbidity from herpes zoster in children with acute lymphoblastic leukemia (ALL).. Reviewing records, treatment and course of zoster eruptions were registered in a cohort of 67 children with newly diagnosed ALL. Of these, 45 had had varicella at the time of diagnosis and 15 contracted varicella or were vaccinated during the course of therapy.. Eleven children had a total of 17 eruptions while receiving chemotherapy. All eruptions were treated with acyclovir, in eight cases intravenously, and in six cases chemotherapy was interrupted. Cutaneous dissemination occurred in two cases, visceral dissemination in none. One child had postherpetic trigeminal neuralgia for two months. The eruption rate was higher among small children than among school-aged children (0.22 vs. 0.13 per year of chemotherapy) and was related to the intensity of chemotherapy (0.30 per year of consolidation treatment vs. 0.13 for maintenance therapy). Three children on prolonged intensive chemotherapy had recurrent zoster episodes.. Chemotherapy causes zoster eruptions in approximately one quarter of children with ALL, and with intensive protocols recurrent zoster can cause significant morbidity. Attempts to improve immunity by vaccine boosting after attaining remission seems warranted.

    Topics: Acyclovir; Adolescent; Antineoplastic Agents; Antiviral Agents; Chickenpox; Child; Child, Preschool; Cohort Studies; Herpes Zoster; Humans; Immunocompromised Host; Infant; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Recurrence; Risk Factors

2009
[Varicella-associated morbidity in children undergoing chemotherapy for acute lymphoblastic leukaemia].
    Ugeskrift for laeger, 2009, Nov-09, Volume: 171, Issue:46

    In children with cancer, varicella can be complicated by visceral dissemination with a risk of fatal outcome, especially in children with acute lymphoblastic leukaemia (ALL). Immunoprophylaxis and antiviral therapy have reduced the mortality, but the morbidity remains significant and is explored here in a cohort of children with ALL.. Among 67 children diagnosed with ALL during 1992-2007, 22 were seronegative for varicella-zoster virus (VZV) at the time of diagnosis. Patient records were reviewed to describe varicella exposures, eruptions and vaccinations during chemotherapy (24-30 months) and the following six months of immune recovery.. Fifteen exposures were recognised in eight children and were managed with oral acyclovir prophylaxis; three resulted in clinical infection. Adoption of brief prophylaxis in the second week of incubation has not - so far - increased the infection rate (one in six versus two in nine). A further six varicella cases occurred without recognised exposure. All nine eruptions (in eight children) were uncomplicated but entailed hospitalisation days for intravenous therapy with acyclovir and loss of chemotherapy days. Seven children were VZV-vaccinated during maintenance chemotherapy; none developed varicella or zoster later in the course.. Despite protective isolation and prophylactic treatment, seronegative children with ALL have a high risk of varicella during or shortly after chemotherapy. We recommend that susceptible siblings should be vaccinated at the time of diagnosis and the child should receive vaccination once oral maintenance chemotherapy has been initiated.

    Topics: Acyclovir; Adolescent; Antineoplastic Agents; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Cohort Studies; Humans; Immunocompromised Host; Infant; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Risk Factors

2009
Varicella zoster virus infection in patients taking the TNF-alpha inhibitor, etanercept: coincidence or causal?
    Hawaii medical journal, 2009, Volume: 68, Issue:11

    Ninety percent of varicella infections are seen in children under the age of ten and usually follow a benign clinical course with complete resolution of symptoms in one to three weeks. Herpes zoster an acute vesicular eruption due to the varicella-zoster virus (VZV), occurs mostly in adults. Biologic agents include tumor necrosis factor alpha (TNF-alpha) inhibitors that have significantly impacted the treatment of autoimmune and inflammatory conditions. Therapy with TNF-alpha inhibitors poses a potential risk of serious infections secondary to their immunomodulating properties; however multiple studies have demonstrated acceptable safety and tolerability profiles. A case of documented VZV infection (varicella) in an adult receiving the TNF-alpha inhibitor etanercept is described here.

    Topics: Acyclovir; Antiviral Agents; Arthritis, Psoriatic; Chickenpox; Etanercept; Hawaii; Herpesvirus 3, Human; Humans; Immunocompetence; Immunoglobulin G; Immunosuppressive Agents; Male; Middle Aged; Psoriasis; Receptors, Tumor Necrosis Factor; Risk Factors; Tumor Necrosis Factor-alpha

2009
Chickenpox-associated fulminant hepatitis that led to liver transplantation in a 63-year-old woman.
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2008, Volume: 14, Issue:9

    A 63-year-old woman treated with prednisone for sinusitis developed fulminant liver failure due to a clinically unsuspected primary varicella zoster virus infection. The diagnosis of herpetic hepatitis was made from a liver biopsy, and varicella zoster virus viremia was detected by polymerase chain reaction. She was treated successfully with transplantation and perioperative administration of acyclovir.

    Topics: Acyclovir; Antiviral Agents; Biopsy; Chickenpox; Female; Herpesvirus 3, Human; Humans; Liver; Liver Failure, Acute; Liver Transplantation; Middle Aged; Polymerase Chain Reaction; Prednisone; Treatment Outcome

2008
Acyclovir-resistant chronic verrucous vaccine strain varicella in a patient with neuroblastoma.
    The Pediatric infectious disease journal, 2008, Volume: 27, Issue:10

    A 21-month-old girl with neuroblastoma developed chronic verrucous Oka strain varicella-zoster infection during chemotherapy. Virus isolated from the patient demonstrated high-level acyclovir resistance, and its thymidine kinase had no in vitro enzymatic activity. After foscarnet therapy, she underwent stem cell transplantation without varicella reactivation. This is only the second reported case of resistant varicella zoster virus caused by Oka strain virus.

    Topics: Acyclovir; Antineoplastic Agents; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Chronic Disease; Drug Resistance, Viral; Female; Herpesvirus 3, Human; Humans; Immunocompromised Host; Infant; Neuroblastoma

2008
[Varicella: frequent questions on treatment and recommendations for management of contacts].
    Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia, 2008, Volume: 25, Issue:5

    Dealing with varicella often causes doubts to general practitioners and pediatricians. In this article the author summaries guidelines based on solid evidence to treat varicella and prevent the disease in susceptible contacts in different clinical scenarios and presents his personal point of view in those controversial aspects commonly resolved by the authorized opinion of experts.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Contact Tracing; Environmental Exposure; Evidence-Based Medicine; Humans; Practice Guidelines as Topic; Risk Factors; Valacyclovir; Valine

2008
Varicella pneumonia with immune thrombocytopenic purpura: a patient with multiple complications.
    Cutis, 2008, Volume: 82, Issue:6

    Viral syndromes can present with various cutaneous manifestations, from the morbilliform eruption of measles to the papular lesions of molluscum. The systemic manifestations of viral illness can be similarly varied, with different presentations in each individual. We describe a patient with recently diagnosed AIDS who presented to the emergency department with hemorrhagic papules and shortness of breath. She was found to be severely thrombocytopenic, and a Tzanck smear revealed multinucleate giant cells. She received a diagnosis of immune thrombocytopenic purpura (ITP) and primary varicella pneumonia. Acyclovir and intravenous immunoglobulin (IVIG) were initiated. Her respiratory status improved after 5 days of treatment and her cutaneous lesions healed, with some scarring. We believe the rapid resolution and benign outcome of this patient's varicella infection may have been attributed to the concomitant initiation of IVIG with antiviral therapy.

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Female; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Pneumonia, Viral; Purpura, Thrombocytopenic

2008
Post-transplant varicella infection.
    The Journal of the Association of Physicians of India, 2008, Volume: 56

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Herpesvirus 3, Human; Humans; Kidney Transplantation; Male; Postoperative Complications; Treatment Outcome

2008
[Cerebral vasculitis with aneurysms caused by varicella-zoster virus infection during AIDS: a new clinicoangiographical syndrome].
    Revue neurologique, 2008, Volume: 164, Issue:1

    We describe three cases of cerebral angiopathy with aneurysms caused by a meningeal varicella-zoster virus infection occurring during AIDS. The clinical picture was rather stereotyped: severe immunocompromission due to HIV infection, ongoing multifocal cerebrovascular disease with territorial infarcts, lymphocytic meningitis with normal glucose content (two cases) or hypoglycorrhachia (one case), multifocal cerebral vasculopathy with narrowings and aneurysms, healing with or without neurological sequelae after intravenous aciclovir treatment. The diagnosis of varicella-zoster virus-induced angiopathy was ascertained by the positive specific PCR in the CSF in the three cases and by the results of the cerebromeningeal biopsy in one case. Although, varicella-zoster virus is already known as a cause of cerebral angiopathy both in the immunocompetent and the immunocompromised, these three cases are the first ever described of a particular angiopathy with narrowings and ectasias complicating AIDS. The infectious treatable cause and the risk of aggravation without treatment require early active oriented investigations in case of a patient with cerebrovascular disease occurring during HIV infection, including a CSF study with varicella-zoster PCR, to allow specific antiviral treatment. In our three cases, aciclovir intravenous treatment (30mg/kg per day) enabled VZ virus clearing from the CSF and stopped the course of the vasculopathy.

    Topics: Acyclovir; Adult; Antiviral Agents; Cerebral Angiography; Chickenpox; Female; Glucose; HIV Infections; Humans; Intracranial Aneurysm; Magnetic Resonance Angiography; Male; Meningitis, Viral; Reverse Transcriptase Polymerase Chain Reaction; Vasculitis, Central Nervous System

2008
Re-infection with primary varicella zoster in older people.
    Age and ageing, 2008, Volume: 37, Issue:2

    Topics: Acyclovir; Aged, 80 and over; Antibodies, Viral; Chickenpox; Follow-Up Studies; Herpesvirus 3, Human; Humans; Male; Polymerase Chain Reaction; Recurrence; Risk Assessment; Severity of Illness Index; Treatment Outcome

2008
Varicella encephalopathy in immunocompetent children.
    Journal of paediatrics and child health, 2007, Volume: 43, Issue:3

    Two previously healthy girls presented acute encephalopathy due to varicella, with severe alteration of the conscious level and seizures. Both patients improved progressively after 15 days, with complete clinical recovery.

    Topics: Acyclovir; Brain Diseases; Chickenpox; Child, Preschool; Female; Humans; Immunocompromised Host; Spain

2007
Outbreak of varicella-zoster virus infection among Thai healthcare workers.
    Infection control and hospital epidemiology, 2007, Volume: 28, Issue:4

    To evaluate the correlation between self-report of a prior history of chickenpox and results of varicella-zoster virus (VZV) immunoglobulin (Ig) G serologic test results in an outbreak of VZV infection among Thai healthcare workers (HCWs) and to conduct a cost-benefit analysis of establishing routine VZV immunization as part of an occupational health program on the basis of the outbreak data.. All exposed patients received prophylaxis and the HCWs in our 3 intensive care units (ICUs) were prospectively evaluated. HCWs were assessed for disease history and serologic evidence of VZV IgG. A cost-benefit analysis was performed.. After 140 HCWs and 18 ICU patients were exposed to VZV, 10 HCWs (7%) with active VZV infection were relieved from work until skin lesions were crusted. Acyclovir (ACV) was prescribed to all 10 HCWs with active disease, and all 18 exposed patients received prophylaxis with ACV. Of 140 HCWs, 100 consented to longitudinal follow-up. Twenty-three (100%) of the HCWs who reported a history of chickenpox also had serologic test results that were positive for VZV IgG, compared with 30 (39%) of 77 HCWs who reported no prior history of chickenpox, yet had test results that were positive for VZV IgG. Reported history of chickenpox had a sensitivity of 43%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 61% with respect to VZV infection immunity. The total cost estimate for this outbreak investigation was $23,087.. An HCW's reported history of chickenpox was a reliable predictor of immunity; a report of no prior history of chickenpox was unreliable. Our cost-benefit analysis suggests that the costs of an occupational health program that included VZV surveillance and immunization for the next 323 HCWs would be approximately equal to the excess costs of $17,227 for the ACV therapy, HCW furloughs, and staff overtime associated with this outbreak.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Cost-Benefit Analysis; Disease Outbreaks; Female; Health Personnel; Herpesvirus 3, Human; Hospitals, University; Humans; Immunization Programs; Infection Control; Infectious Disease Transmission, Patient-to-Professional; Medical History Taking; Occupational Exposure; Thailand

2007
Development of varicella during adalimumab therapy.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2007, Volume: 21, Issue:5

    Topics: Acyclovir; Adalimumab; Adult; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antirheumatic Agents; Antiviral Agents; Arthritis, Rheumatoid; Chickenpox; Female; Humans

2007
Varicella-zoster infection with encephalopathy, pneumonia, and renal failure: a case report.
    Renal failure, 2007, Volume: 29, Issue:3

    Primary varicella-zoster (VZ) infection is rare in adults, but the rate of morbidity and mortality is higher than in children. Pneumonia is the most common complication of primary VZ infection in adults. Moreover, varicella pneumonia associated with acute renal failure and acute encephalopathy is very rare. This study reports on a case of disseminated VZ infection successfully treated with acyclovir. The patient was otherwise healthy and denied previous systemic or infectious disease. The initial diagnosis was varicella pneumonia. However, multiple organ involvement subsequently was found in several organs, including the kidney, brain, lung, liver, blood, and skin. The reactivation of VZ infection was strongly suspected. Abnormal renal and liver function and thrombocytopenia also were noted. The patient with chickenpox was treated successfully with acyclovir without complication. In conclusion, multiple organ involvement is a rare complication of VZ infection in adults. In the severe case presented here, adequate intravenous acyclovir administration and close observation of the general condition were essential for successfully treating disseminated VZ infection without complications.

    Topics: Acute Kidney Injury; Acyclovir; Adult; Antiviral Agents; Chickenpox; Encephalitis, Varicella Zoster; Herpesvirus 3, Human; Humans; Male; Pneumonia, Viral

2007
Systemic varicella zoster virus reinfection in a case of angioimmunoblastic T-cell lymphoma.
    The Journal of dermatology, 2007, Volume: 34, Issue:6

    Angioimmunoblastic T-cell lymphoma (AITL) is a rare subtype of peripheral T-cell lymphoma that causes immunological disorders such as immunosuppression, autoimmune disease-like symptoms and allergy. We report a case of a 67-year-old man with AITL who had a serious varicella zoster virus (VZV) reinfection that appeared clinically to be varicella. Forty percent of cases of AITL are associated with skin rash. A variety of cutaneous manifestations have been reported; however, the majority are macropapular eruptions that are often diagnosed as drug associated. Our study emphasizes the need to correctly diagnose opportunistic infections, such as the varicella that is documented in our patient, at early stages in AITL.

    Topics: Acyclovir; Aged; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Chickenpox; Cyclophosphamide; Diagnosis, Differential; Doxorubicin; Herpesvirus 3, Human; Humans; Immunocompromised Host; Infusions, Intravenous; Lymphoma, T-Cell; Male; Prednisone; Recurrence; Vincristine

2007
Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP).
    MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2007, Jun-22, Volume: 56, Issue:RR-4

    Two live, attenuated varicella zoster virus-containing vaccines are available in the United States for prevention of varicella: 1) a single-antigen varicella vaccine (VARIVAX, Merck & Co., Inc., Whitehouse Station, New Jersey), which was licensed in the United States in 1995 for use among healthy children aged > or = 12 months, adolescents, and adults; and 2) a combination measles, mumps, rubella, and varicella vaccine (ProQuad, Merck & Co., Inc., Whitehouse Station, New Jersey), which was licensed in the United States in 2005 for use among healthy children aged 12 months-12 years. Initial Advisory Committee on Immunization Practices (ACIP) recommendations for prevention of varicella issued in 1995 (CDC. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1996;45 [No. RR-11]) included routine vaccination of children aged 12-18 months, catch-up vaccination of susceptible children aged 19 months-12 years, and vaccination of susceptible persons who have close contact with persons at high risk for serious complications (e.g., health-care personnel and family contacts of immunocompromised persons). One dose of vaccine was recommended for children aged 12 months-12 years and 2 doses, 4-8 weeks apart, for persons aged > or = 13 years. In 1999, ACIP updated the recommendations (CDC. Prevention of varicella: updated recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1999;48 [No. RR-6]) to include establishing child care and school entry requirements, use of the vaccine following exposure and for outbreak control, use of the vaccine for certain children infected with human immunodeficiency virus, and vaccination of adolescents and adults at high risk for exposure or transmission. In June 2005 and June 2006, ACIP adopted new recommendations regarding the use of live, attenuated varicella vaccines for prevention of varicella. This report revises, updates, and replaces the 1996 and 1999 ACIP statements for prevention of varicella. The new recommendations include 1) implementation of a routine 2-dose varicella vaccination program for children, with the first dose administered at age 12-15 months and the second dose at age 4-6 years; 2) a second dose catch-up varicella vaccination for children, adolescents, and adults who previously had received 1 dose; 3) routine vaccination of all healthy persons aged > or = 13 years without evidence of immunity; 4) prenatal assessment and postpartum v

    Topics: Acyclovir; Adolescent; Adult; Antibodies, Viral; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Drug Storage; Herpes Zoster; Humans; Immunization Schedule; Infant; Measles-Mumps-Rubella Vaccine; Vaccines, Combined

2007
An outbreak of chickenpox in adult renal transplant recipients.
    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2007, Volume: 5, Issue:1

    Infection with the varicella-zoster virus, the etiologic agent of chickenpox and herpes zoster, is more serious in immunosuppressed renal transplant recipients than it is in the general population. Chickenpox is a rare infection in adult renal transplant recipients; however, it is significant owing to the severity of its clinical features and its associated high mortality rate. To date, there are no reported outbreaks of primary varicella-zoster virus infection in adult renal transplant recipients. Here, we report 3 patients with chickenpox who presented to our center between May 2006 and June 2006.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Disease Outbreaks; Drug Therapy, Combination; Humans; Immunosuppressive Agents; Injections, Intravenous; Iran; Kidney Transplantation; Male; Treatment Outcome

2007
Recurrent herpes zoster in early childhood.
    Indian journal of pediatrics, 2007, Volume: 74, Issue:8

    Herpes Zoster is produced by reactivation of latent Varicella Zoster Virus from the dorsal root ganglion of sensory nerves. It is common in older individuals and rarely described in the pediatric age group. We report a case of recurrent herpes zoster in a 3-year-old HIV positive child involving T4 dermatome on the first occasion and subsequently involving T10 dermatome. The child responded well to oral acyclovir.

    Topics: Acyclovir; AIDS-Related Opportunistic Infections; Antiviral Agents; Chickenpox; Humans; Infant; Male; Recurrence

2007
[Radiograph patterns in herpes simples virus I pneumonia in the adult].
    Anales de medicina interna (Madrid, Spain : 1984), 2007, Volume: 24, Issue:8

    The aim of this study is to describe epidemiology, patogénesis, pulmonary manifestations and Rx findings in adult patients with varicella pneumonia (VP). Four patients were studied. The diagnosis was established by clinical and radiologic criteria. All had fever , esanthem, 3 cough, 2 dyspnea. Chest X-ray showed interstitial micronodular pattern at bases. 1 case developed airspace consolidation by Staphylococcus aureus. 2 were admitted to ICU. The four received IV acyclovir. We concluded that adults patients with VP usually show nodular infiltrates, with favourable course.

    Topics: Acyclovir; Adult; Age Factors; Antiviral Agents; Chickenpox; Female; Herpesvirus 1, Human; Humans; Male; Pneumonia, Viral; Radiography, Thoracic; Time Factors; Tomography, X-Ray Computed; Treatment Outcome

2007
Varicella chorioretinitis.
    Acta ophthalmologica Scandinavica, 2007, Volume: 85, Issue:8

    Topics: Acyclovir; Administration, Oral; Administration, Topical; Adolescent; Anti-Inflammatory Agents; Antiviral Agents; Chickenpox; Chorioretinitis; Drug Administration Schedule; Drug Therapy, Combination; Fluocortolone; Fundus Oculi; Humans; Male; Steroids; Visual Acuity

2007
[What is your diagnosis? (Solution on the next page)].
    Praxis, 2007, Dec-19, Volume: 96, Issue:51-52

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Follow-Up Studies; Humans; Male; Pneumonia, Viral; Radiography, Thoracic; Time Factors; Treatment Outcome

2007
Varicella-induced hemolytic anemia with hepatitis.
    Annals of hematology, 2006, Volume: 85, Issue:1

    Topics: Acyclovir; Anemia, Hemolytic, Autoimmune; Anti-Inflammatory Agents; Antiviral Agents; Chickenpox; Heart Failure; Hepatitis, Viral, Human; Hepatomegaly; Herpesvirus 3, Human; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Infant; Male; Methylprednisolone; Prednisolone; Splenomegaly

2006
Fatal varicella infection in a girl with systemic lupus erythematosus after oral acyclovir prophylaxis.
    European journal of pediatrics, 2006, Volume: 165, Issue:4

    Topics: Acyclovir; Adolescent; Antiviral Agents; Aspergillosis; Azathioprine; Brain; Chickenpox; Disseminated Intravascular Coagulation; Fatal Outcome; Female; Humans; Immunosuppressive Agents; Lung; Lupus Erythematosus, Systemic; Lymphohistiocytosis, Hemophagocytic; Meninges; Multiple Organ Failure; Myocardium; Opportunistic Infections; Prednisolone

2006
Two cases of varicella zoster virus meningitis found in pediatric patients after bone marrow transplantation despite valaciclovir prophylaxis and without skin lesions.
    Journal of medical virology, 2006, Volume: 78, Issue:4

    Two cases of varicella zoster virus (VZV) meningitis are described in an 18-year-old girl and an 18-year-old boy. They occurred, respectively, 9 days and 9 months after allogeneic bone marrow transplantation. VZV nucleic acid was detected in the cerebrospinal fluid during the 1st week of illness. This recurrence occurred despite valaciclovir prophylaxis and without skin lesions. The two patients received aciclovir intravenously and immunoglobulins infusion. They responded to treatment and their clinical state improved rapidly.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Bone Marrow Transplantation; Cerebrospinal Fluid; Chemoprevention; Chickenpox; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Meningitis, Viral; Valacyclovir; Valine

2006
Use of genomic analysis of varicella-zoster virus to investigate suspected varicella-zoster transmission within a renal unit.
    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2006, Volume: 36, Issue:1

    The source of hospital-acquired chickenpox infection may be presumed from a known exposure, but has not been previously proven using genomic analysis.. Investigation of suspected VZV transmission was done using single nucleotide polymorphism genomic analysis.. Comparison was made of viral isolates from two patients with chickenpox on the same ward who were not known to have had direct contact.. An identical genotype in the variable R1 region of the VZV was isolated from the two patients.. Inapparent hospital-acquired transmission was the most likely route of infection.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Cross Infection; DNA, Viral; Fluorescent Antibody Technique; Genomics; Herpesvirus 3, Human; Hospital Units; Humans; Polymerase Chain Reaction; Polymorphism, Single Nucleotide; Treatment Outcome

2006
Specific autologous cytotoxic T lymphocytes for chronic varicella in a liver transplanted child.
    Pediatric transplantation, 2006, Volume: 10, Issue:2

    Infections by herpesviruses may have severe complications in liver transplant patients. Although prophylactic varicella zoster virus vaccination is strongly recommended and widely applied, severe infection may still occur. We report the case of systemic chronic varicella, which developed in a liver allograft recipient, unresponsive to antiviral drug treatment, successfully treated by varicella zooster-specific CTL. Graft failure ensued, likely, because of massive cytolysis of infected hepatocytes. The patient, who was re-transplanted in the absence of signs of varicella zooster reactivation, is now well and disease free 3 yr after second liver transplant.

    Topics: Acyclovir; Antiviral Agents; Biliary Atresia; Chickenpox; Child, Preschool; Chronic Disease; Female; Humans; Liver; Liver Function Tests; Liver Transplantation; Reoperation; T-Lymphocytes, Cytotoxic; Transplantation, Homologous

2006
CT appearance of Varicella Zoster lesions in liver and spleen in an immunocompetent patient.
    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2006, Volume: 36, Issue:4

    An adult patient presented with vesicular rash and abdominal pain of 5 days duration. His initial laboratory results showed elevated liver enzymes. A contrast enhanced CT scan demonstrated multiple small hypodense nodules in liver and spleen. His serum was reactive for Varicella Zoster IgM. Patient was treated with intravenous Acyclovir for 5 days and followed up with oral tablets for 2 weeks. At 3 weeks, CT scan showed resolution of hypodense nodules and his serum liver enzymes returned to normal at 6 weeks. Patient is on follow up and asymptomatic for 2 years. The CT appearances of nodules and their resolution following specific antiviral therapy are useful in diagnosis and in follow up of disseminated Varicella Zoster.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Follow-Up Studies; Humans; Immunocompetence; Length of Stay; Liver; Male; Spleen; Time Factors; Tomography, X-Ray Computed; Treatment Outcome

2006
Atypical varicella zoster as SJS-TEN overlap syndrome with involvement of palm and sole.
    Nepal Medical College journal : NMCJ, 2006, Volume: 8, Issue:1

    A 14-month-old boy presented with generalised vesicular eruption involving the face, trunk and extremities accompanied by high grade fever. He had associated redness and purulent discharge from both eyes. Examination revealed erosions on the tongue, soft palate and genitalia with haemorrhagic crusts on the lips and nasal orifices. All laboratory investigations were within normal limits except leucocytosis. Chest x-ray showed left middle zone pneumonitis. Treatment was by paracetamol, antibiotics and oral acyclovir. Desquamation started from the eighth day. Our purpose in reporting this case is to highlight the fact that varicella can be atypical with distal involvement and can present as SJS-TEN overlap syndrome.

    Topics: Acyclovir; Chickenpox; Comorbidity; Diagnosis, Differential; Foot; Hand; Herpesvirus 3, Human; Humans; Infant; Male; Stevens-Johnson Syndrome

2006
Varicella-associated colitis in a 6-month-old infant.
    Journal of pediatric gastroenterology and nutrition, 2006, Volume: 43, Issue:5

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Colitis; Humans; Immunocompetence; Infant; Male

2006
[Varicella pneumonia in adult population: review of 21 cases].
    Revista clinica espanola, 2006, Volume: 206, Issue:11

    Retrospective study of the varicella pneumonia in adults, in order to know incidence, environmental and clinical characteristics and treatments of patients with this diagnosis during the last 9 years in Toledo.. Twenty-one adult patients with the diagnosis of varicella pneumonia were studied, using the information of clinical histories and codified data. The backgrounds of pregnancy, smoking habit, concomitant diseases, previous contacts with another patients and the season of the year, were evaluated. Diagnosis was established by clinical and radiologic criteria in the course of varicella infection.. 21 patients (10 males and 11 females, between 25 and 73 years) were studied. 17 (81%) were smokers, in 15 (71.4%) there was documented contact with varicella infection and 4 (19%) were immunocompromised. In the first 3-7 days after the development of skin lesions (100%), there was fever in 20 cases (95.2%) and dyspnea in 14 (66.7%). There were 4 patients (33,3%) without respiratory symptoms and in 5 (23,8%) there was important hypoxemia. Evolution was satisfactory in 20 cases (95.2%); three others requiring admission to Intensive Care Unit. Chest X-ray revealed an interstitial pattern in 11 cases (52.4%), nodular in 4 (19%) and a mixed pattern in 5 (23.8%). 20 patients were treated with acyclovir and in one case with foscarnet. In 28.57% cases, corticosteroids were needed.. We believe smoking habit could be a risk factor related to an increase of varicella pneumonia. A chest X-ray should be made in every patient, despite the symptoms. Adults with pneumonia have a better prognosis if acyclovir is started early in time. Concomitant treatment with corticosteroids should be used in those cases with respiratory insufficiency.

    Topics: Acyclovir; Adult; Aged; Antiviral Agents; Chickenpox; Female; Humans; Male; Middle Aged; Pneumonia, Viral; Retrospective Studies; Risk Factors; Treatment Outcome

2006
Varicella-vaccine failure in an outbreak in an elementary school in Minnesota.
    The Journal of infectious diseases, 2005, Jan-15, Volume: 191, Issue:2

    Topics: Acyclovir; Chickenpox; Chickenpox Vaccine; Child; Disease Outbreaks; Health Policy; Herpesvirus 3, Human; Humans; Male; Minnesota; Schools; Severity of Illness Index; Treatment Failure; Vaccination

2005
[Retrobulbar optic nevritis and chicken pox: a case report in a child].
    Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 2005, Volume: 12, Issue:3

    We report here the case of a three-year-old boy presenting with an optic neuritis during the invasive phase of a chicken pox. This clinical, infrequent picture, can be directly due to the virus or be secondary to an auto-immune mechanism. The examination of the ocular fundus, the profile of the spinal fluid, the MRI and the measure of visual evoked potential allow to reach diagnosis and to identify the type of lesion. There is no consensus on the treatment of this optic neuritis and the current attitude is therapeutic abstention because of a rapid spontaneous improvement. Cerebellitis, meningitis can also be seen during chicken pox. Their evolution is quickly favorable, not requiring additional exam. Encephalitis can result from an auto-immune lesion of the white matter and require then the use of corticoids with antiviral drugs.

    Topics: Acyclovir; Antiviral Agents; Ataxia; Chickenpox; Child, Preschool; Electroencephalography; Encephalitis, Viral; Evoked Potentials, Visual; Follow-Up Studies; Fundus Oculi; Humans; Magnetic Resonance Imaging; Male; Myoclonus; Optic Neuritis; Prognosis; Time Factors

2005
The effect of low-dose aciclovir on reactivation of varicella zoster virus after allogeneic haemopoietic stem cell transplantation.
    Bone marrow transplantation, 2005, Volume: 35, Issue:11

    Patients undergoing haemopoietic stem cell transplants (HSCT) are at high risk of varicella zoster virus (VZV) reactivation, with a significant incidence of dissemination. This study reports a retrospective analysis of 247 allogeneic HSCT recipients receiving anti-viral prophylaxis with low-dose oral aciclovir 400 mg/day, administered until immunosuppression was discontinued and the CD4(+) cell count exceeded 200/mm(3). Viral reactivation was successfully suppressed by aciclovir prophylaxis, with only one case of breakthrough infection. The cumulative incidence of zoster infection at 1 year post transplant was 2% and at 5 years 34%. In all, 64 patients discontinued prophylaxis. Zoster developed in 26 of these, giving a cumulative incidence of infection at 1 year after stopping aciclovir of 39% and at 3 years 44%. Infection occurred in a localised dermatomal distribution in 93% of cases. This supports previous findings that aciclovir prophylaxis prevents early VZV reactivation, although the long-term incidence is not affected as infection occurs once prophylaxis is discontinued. Such infection, however, is mild and localised. This study does not support the idea that use of such low-dose aciclovir regimens reduces the zoster incidence by permitting subclinical reactivation during prophylaxis, and therefore the re-establishment of protective anti-viral immunity.

    Topics: Acyclovir; Adult; Antiviral Agents; CD4-Positive T-Lymphocytes; Chickenpox; Cohort Studies; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunosuppressive Agents; Leukemia; Middle Aged; Postoperative Complications; Retrospective Studies; Risk Factors; T-Lymphocytes; Time Factors; Transplantation Conditioning; Transplantation, Homologous

2005
[Varicella pneumonia in adults: study of 17 cases].
    Atencion primaria, 2005, Sep-30, Volume: 36, Issue:5

    Topics: Acyclovir; Adult; Age Factors; Antiviral Agents; Chickenpox; Female; Humans; Male; Pneumonia, Viral; Radiography; Smoking; Treatment Outcome

2005
Analysis of the cost-effectiveness of varicella vaccine programmes based on an observational survey in the Latium region of Italy.
    Herpes : the journal of the IHMF, 2005, Volume: 12, Issue:2

    Varicella is the most widespread childhood disease in Italy. However, as in many parts of the world, the country does not yet have a unified approach to the management of the disease. A cost-effectiveness analysis of varicella vaccination strategies, using the Latium region in Italy as a case study, was undertaken. Mass vaccination is only recommended if the immunization programme can achieve coverage of over 85% in a short time. However, experience in Italy with non-compulsory vaccinations has shown this is difficult to achieve. Consequently, eradication of the disease is not seen as an attainable short-term goal. For mass varicella vaccination to be successful, it must be run at a national as well as regional level in combination with education programmes, and a reliable surveillance system. The interaction between varicella and herpes zoster must also be taken into account when considering vaccination strategies, as zoster vaccination strategies may have an impact on varicella coverage.

    Topics: Acyclovir; Analgesics, Non-Narcotic; Anti-Infective Agents; Chickenpox; Cost-Benefit Analysis; Health Care Costs; Herpes Zoster; Histamine H1 Antagonists; Humans; Italy; Vaccination; Viral Vaccines

2005
Varicella pneumonia in immunocompetent adults: report of two cases, with emphasis on high-resolution computed tomography findings.
    The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, 2005, Volume: 9, Issue:3

    We report two cases of varicella pneumonia in immunocompetent patients, with emphasis on high-resolution computer tomography manifestations. The predominant findings consisted of multiple bilateral nodules, ranging from 1-10 mm in diameter, with or without a surrounding halo of ground-glass attenuation. Other findings include ground-glass opacities, focal areas of consolidation and small pleural effusions.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Immunocompromised Host; Pneumonia, Viral; Tomography, X-Ray Computed

2005
Demonstration of varicella zoster virus in a case of presumed seasonal hyperacute panuveitis.
    Indian journal of ophthalmology, 2005, Volume: 53, Issue:4

    Topics: Acute Disease; Acyclovir; Adult; Antiviral Agents; Chickenpox; Herpesvirus 3, Human; Humans; Male; Nepal; Panuveitis; Seasons

2005
Congenital varicella syndrome.
    European journal of pediatrics, 2004, Volume: 163, Issue:6

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Female; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Pregnancy; Pregnancy Complications, Infectious; Vaccination

2004
Immunoprophylaxis or acyclovir prophylaxis against hospital-acquired varicella.
    The Journal of hospital infection, 2004, Volume: 58, Issue:1

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Cross Infection; Female; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal

2004
[Facial palsy and central nervous system infection with varicella virus following adult chickenpox].
    Revue neurologique, 2004, Volume: 160, Issue:10

    VZV virus-related peripheral neuropathies usually occur after shingles in adults and more rarely after chickenpox in childhood.. A 54-year-old patient presented with a right VIIth nerve palsy following a chickenpox rash and recovered after antiviral treatment. CSF analysis revealed lymphocytic meningitis and the virus was identified by PCR.. Although previous chickenpox was not found in the patient's past history, the probability of reinfection is likely. The virus can be assumed to affect the nervous system directly; the axonal or demyelinating mechanism of the neuropathy may be discussed.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Demyelinating Diseases; Facial Nerve Diseases; Facial Paralysis; Herpesvirus 3, Human; Humans; Male; Meningitis; Middle Aged

2004
Epidural blood patch and acute varicella.
    Anesthesia and analgesia, 2004, Volume: 99, Issue:6

    We present the case of a 38-yr-old woman who required an epidural blood patch in the context of acute varicella (chickenpox). The unique risks in this case include the possible triggering of central nervous system complications after the introduction of viremic blood into the epidural or intrathecal space. However, the risk was believed to be acceptable because the patient was receiving antiviral coverage. She enjoyed complete relief of her headache but experienced transient back and leg pain. Leptomeningeal irritation caused by acute varicella infection may put patients at increased risk for pain after epidural blood patch.

    Topics: Acute Disease; Acyclovir; Adult; Antiviral Agents; Blood Patch, Epidural; Chickenpox; Female; Headache; Humans; Magnetic Resonance Imaging; Pain; Spinal Cord; Valacyclovir; Valine

2004
Disseminated primary varicella infection during infliximab treatment.
    The Journal of rheumatology, 2004, Volume: 31, Issue:12

    A young man developed a serious disseminated varicella infection, necessitating antiviral treatment, after being treated with anti-tumor necrosis factor-alpha therapy for rheumatoid arthritis.

    Topics: Acyclovir; Adult; Antibodies, Monoclonal; Arthritis, Rheumatoid; Chickenpox; Follow-Up Studies; Humans; Immunocompromised Host; Infliximab; Injections, Intravenous; Male; Risk Assessment; Severity of Illness Index; Tumor Necrosis Factor-alpha

2004
Economic burden of varicella in Singapore--a cost benefit estimate of implementation of a routine varicella vaccination.
    The Southeast Asian journal of tropical medicine and public health, 2004, Volume: 35, Issue:3

    Varicella is a common childhood illness that can result in significant morbidity and mortality. As early as 1995, recommendations for routine varicella vaccination have been published, but have not been universally implemented, with cost of vaccination as a major reason. Though available from 1996, the vaccine has yet to be routinely implemented in Singapore. We set out to assess the economic burden of varicella and the cost-benefit of adding a varicella vaccine to the existing immunization schedule in Singapore. In this study, using data from 1994--1995 the direct cost estimates were based on all levels of medical care; inpatient care, emergency room visits, primary health care and medication. Indirect costs were estimated from the cost of time lost by patients and their families attending to medical needs, as well as loss of productivity due to absenteeism. The cost of a vaccination program targeted at 15-month old infants receiving concomitant measles-mumps-rubella immunization was also assessed. The cost-benefit ratio was then estimated. The total cost of varicella in Singapore was estimated to be US$11.8 million per annum. The loss of productivity accounted for a large proportion of the total cost as a lot of parents took leave when their children were ill. The estimates of total cost represent approximately US$188 per varicella case per year. In comparison, the cost of a vaccination program was found to be US$3.3 million per annum. The cost per case averted was US$104. From a societal point of view, for every dollar invested in a vaccination program, we would save about US$2 dollars.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Cost of Illness; Cost Savings; Cost-Benefit Analysis; Efficiency; Health Care Costs; Health Resources; Hospitalization; Humans; Immunization Programs; Infant; Measles-Mumps-Rubella Vaccine; Office Visits; Singapore

2004
Photolocalized varicella.
    Acta dermato-venereologica, 2004, Volume: 84, Issue:6

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child, Preschool; Female; Fever; Humans; Photosensitivity Disorders; Sunlight

2004
[Opportunistic infections in patients with inflammatory bowel disease undergoing immunosuppressive therapy].
    Gastroenterologia y hepatologia, 2003, Volume: 26, Issue:1

    Immunosuppressive agents (azathioprine, methotrexate) are increasingly being used in the treatment of inflammatory bowel disease. The use of immunosuppressive agents is associated with a greater risk of opportunistic infections, the most frequent of which are those caused by cytomegalovirus and varicella zoster virus. We present four cases of opportunistic infections due to Herpesviruses in patients undergoing immunosuppressive treatment with azathioprine for Crohn's disease. We also review the literature published on this topic. Two patients presented cutaneous varicella complicated by pneumonia and esophagitis respectively, one patient had cutaneous herpes zoster and the other had fatal pneumonia possibly caused by the Herpesvirus. In the first three the clinical course of the infection was favorable after withdrawing immunosuppressant treatment and initiating treatment with aziclovir. In patients Crohn's disease azathioprine treatment increases the risk of opportunistic infection by Herpesvirus. However, in the absence of other factors that increase immunosuppression, these infections usually have a benign course with specific antiviral therapy.

    Topics: Acyclovir; Adult; Aged; Antiviral Agents; Azathioprine; Chickenpox; Crohn Disease; Disease Susceptibility; Esophageal Diseases; Fatal Outcome; Female; Ganciclovir; Hepatitis, Viral, Human; Herpes Zoster; Herpesviridae Infections; Humans; Immunosuppressive Agents; Leukopenia; Lymphopenia; Male; Opportunistic Infections; Pneumonia, Viral

2003
The primary varicella infection near term: a case report.
    Archives of gynecology and obstetrics, 2003, Volume: 268, Issue:2

    A 33-year-old pregnant woman developed skin rash at the 40 weeks' gestation. She was diagnosed as primary varicella zoster infection. Upon hospitalization, she was administered acyclovir and also a tocolytic agent (ritodorine hydrochloride) to postpone labor. The patient delivered a female baby 7 days after she developed skin lesions. Serological tests conducted after delivery showed that the mother was positive for IgG and IgM against varicella zoster. The baby was observed in a neonatal intensive care unit and found to be free of varicella zoster symptoms.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Tocolytic Agents

2003
[Varicella and Kawasaki syndrome: cause or association?].
    Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 2003, Volume: 10, Issue:4

    Topics: Acyclovir; Anti-Bacterial Agents; Antiviral Agents; Causality; Chickenpox; Drug Therapy, Combination; Echocardiography; Female; Humans; Infant; Mucocutaneous Lymph Node Syndrome

2003
Varicella in pediatric liver transplant patients: a retrospective analysis of treatment and outcome.
    Journal of pediatric gastroenterology and nutrition, 2003, Volume: 37, Issue:2

    Varicella is a common childhood disease that can cause morbidity and mortality among immunosuppressed patients. There have been few previous studies monitoring the course of pediatric liver transplant patients with acute varicella. The aim of this study was to evaluate the treatment, outcomes, and complications of pediatric liver transplant patients admitted with acute varicella infection.. A retrospective chart review was carried out based on discharge diagnoses of orthotopic liver transplant and varicella among pediatric patients (age range, birth-18 years) admitted to the UCLA Medical Center between 1985 and 2001.. Five hundred fifty-six pediatric patients received liver transplantations between 1985 and 2001. Twenty-two of these patients were admitted to the UCLA Medical Center with varicella (11 females, 11 males). No patients were treated on an outpatient basis. Mean age of the patients was 6 years (range, 1-16 years). None of these patients received the varicella vaccine before hospitalization. On admission, 5 of 22 patients (23%) had received varicella zoster immunoglobulin within 96 hours of exposure. The mean length of hospitalization was 6 days (range, 2-11 days). All immunosuppression dosages were reduced during the admissions. None of the patients had been treated with high-dose corticosteroids for acute rejection before the onset of the varicella infection. Patients were treated until defervescence with intravenous acyclovir and until their varicella lesions crusted. Patients were discharged with oral acyclovir to complete a 10-day course (including the intravenous treatment). No patients had complications from the varicella infection. A complication of an elevated serum creatinine for one patient was noted with the intravenous acyclovir treatment. This patient had associated headache and nausea that resolved when the creatinine level returned to normal.. There were no complications or dissemination of varicella infection among our pediatric liver transplant patients. Further prospective randomized trials are required to evaluate the management of pediatric liver transplant patients infected with varicella.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Female; Herpesvirus 3, Human; Hospitalization; Humans; Immunocompromised Host; Immunosuppressive Agents; Infant; Liver Transplantation; Male; Postoperative Complications; Retrospective Studies; Safety; Treatment Outcome

2003
Spread of varicella-zoster virus DNA to the environment from varicella patients who were treated with oral acyclovir.
    Pediatrics international : official journal of the Japan Pediatric Society, 2003, Volume: 45, Issue:4

    The purpose of the present study was to determine the degree of spread of varicella-zoster virus to the environment (VZV) from varicella patients who received oral acyclovir treatment.. Over a period of 8 months, seven healthy children (two girls and five boys, 23-64 months of age) with varicella who visited Fujita Health University School of Medicine were treated with routine doses of oral acyclovir (ACV) for 5 days, commencing within 24 h after onset of the disease. Swab samples from the throats of patients and their family members as well as from air purifier filters in their houses were collected for 7 days as frequently as possible after starting treatment for the disease. The VZV DNA in the samples was identified by a sensitive polymerase chain reaction amplification assay.. The VZV DNA was detected in 33-100% of throat swab samples from varicella patients by day 7 of the disease, in 17-32% of throat swab samples from family members by day 4 and in 29% of filters from air purifiers by day 3.. The results suggest a broad spread of VZV, probably by the airborne route, from the patients with varicella even after the administration of oral ACV.

    Topics: Acyclovir; Air Microbiology; Antiviral Agents; Chickenpox; DNA, Viral; Family Health; Female; Herpesvirus 3, Human; Humans; Infant; Male; Pharynx

2003
Varicella infection in a pediatric AIDS patient presenting as umbilicated papules.
    Asian Pacific journal of allergy and immunology, 2003, Volume: 21, Issue:1

    An 8-year-old girl with acquired immunodeficiency syndrome presented with fever and alteration of consciousness. She had a history of persistent cryptococcal meningitis. She developed multiple discrete umbilicated papules that resembled cutaneous cryptococcosis on the second day of admission. Skin biopsy revealed an ulcer with a wedge-shaped necrosis of the dermis. The edge of the ulcer showed intracellular edema, margination of nucleoplasm and multinucleated cells, consistent with herpes infection. The diagnosis of varicella-zoster virus infection was confirmed by the identification of herpesvirus DNA from the lesion and differentiation from other herpesviruses by restriction fragment length polymorphism (RFLP) method. Intravenous acyclovir was given at a dose of 500 mg/m2, three times daily for 14 days which resulted in resolution of the skin lesions within 2 weeks.

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Antiviral Agents; Chickenpox; Child; DNA, Viral; Exanthema; Fatal Outcome; Female; Herpesvirus 3, Human; Humans; Polymorphism, Restriction Fragment Length; Skin Ulcer

2003
Disseminated varicella infection in adult renal allograft recipients: role of mycophenolate mofetil.
    Transplantation proceedings, 2003, Volume: 35, Issue:5

    Disseminated varicella zoster virus (VZV) infection is a rare complication after renal transplantation in adults. We report 4 cases diagnosed in our transplant patients. One of which was a primary infection (chicken pox) with multivisceral involvement (hepatitis, pneumonitis, myocarditis, and disseminated intravascular coagulation). The other 3 patients VZV-seropositive before transplantation suffered from disseminated zoster. No immunosuppressive drug was significantly associated with a higher risk of disseminated VZV infection. However, from our experience, we believe that mycophenolate mofetil (MMF), plays a part in the clinical presentation of the disease. Early treatment with high doses of acyclovir is fundamental in infection control. It is essential to perform a pretransplantation serological VZV study on all patients.

    Topics: Acyclovir; Adult; Aged; Antiviral Agents; Chickenpox; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunosuppressive Agents; Incidence; Kidney Transplantation; Male; Middle Aged; Mycophenolic Acid

2003
[Infections caused by Varicella Zoster virus in children with cancer aged less than 15 years old].
    Revista medica de Chile, 2003, Volume: 131, Issue:7

    Infections caused by Varicella Zoster virus in children with cancer have a high rate of complications and mortality.. To report the outcome of this infection in children with cancer.. Retrospective analysis of medical records of 216 children aged less than 15 years old with the diagnosis of an hematological or solid tumor, admitted to the National Program of Antineoplastic Drugs (PINDA).. Eighty seven children had a Varicella Zoster virus infections, 73 (84%) had varicella, 8 (9%) had herpes zoster and 6 (7%) had varicella and herpes zoster. Ninety four percent acquired the infection during antineoplastic treatment and 78% received Acyclovir as antiviral therapy. During a nosocomial outbreak of varicella, three patients with an Acute Lymphoblastic leukemia died in the initial phase of chemotherapy, in spite of an early administration of Acyclovir. No patient with herpes zoster died.. The incidence of varicella was higher in children with leukemia or lymphoma than in children with other types of cancer. Virus reactivation was uncommon and had a benign course. Varicella mortality in these children could be favorably modified through an active immunization of immunocompetent children.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Incidence; Infant; Infant, Newborn; Neoplasms; Retrospective Studies

2003
Persistent multiple pulmonary nodules in a nonimmunocompromised woman after varicella-related myelitis treated with acyclovir.
    Journal of clinical microbiology, 2003, Volume: 41, Issue:10

    Persistent multiple pulmonary nodules were observed on the chest X ray of a nonimmunocompromised woman 6 months after she was treated with acyclovir for a varicella-related myelitis without respiratory symptoms. Early antiviral therapy given for varicella infections might decrease the intensity of clinical symptoms without actually preventing the occurrence of varicella-zoster virus-related lesions such as the persistent pulmonary nodules reported here.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Herpesvirus 3, Human; Humans; Immunocompetence; Middle Aged; Myelitis; Radiography, Thoracic; Solitary Pulmonary Nodule

2003
Resolution of chicken pox neuroretinitis with oral acyclovir: a case report.
    Ocular immunology and inflammation, 2003, Volume: 11, Issue:4

    It is usual to consider chicken pox as a benign infectious disease with a few anterior segment ocular complications like conjunctivitis, keratitis, episcleritis, scleritis, iridocyclitis, and glaucoma. The retinal manifestations are necrotising retinitis, vitritis, neuroretinitis, and retinal detachments. We report a case of neuroretinitis following chicken pox in a 23-year-old male. The complication was resolved by treatment with oral acyclovir in combination with systemic steroids. This report highlights the necessity for fundus examination in cases of chickenpox exhibiting visual symptoms.

    Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Eye Infections, Viral; Glucocorticoids; Humans; Male; Prednisolone; Retinitis

2003
Severe infection by varicella virus in an adult with ulcerative colitis: favourable response to acyclovir treatment.
    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2002, Volume: 34, Issue:5

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Colitis, Ulcerative; Humans; Male

2002
Antiviral treatment of varicella in pediatric practice in the Latium region of Italy: results of an observational study.
    The Pediatric infectious disease journal, 2002, Volume: 21, Issue:8

    The optimal management of chickenpox in children is a controversial issue, at least in Europe. This study was designed to describe chickenpox in children and its reported management by pediatricians working for the National Health Service in the Latium region of Italy.. A questionnaire collected information on the duration, complications and treatment of the disease between September, 1998, and May, 1999, by participant pediatricians who enrolled 1094 patients in community pediatric practice.. Secondary and tertiary cases of the disease in the same household were more severe than the primary cases. Acyclovir was given to 50% of the children, with a tendency to treat more severely ill children. The duration of the disease was significantly less in children receiving acyclovir within the first 24 h of rash (7.6 days 9.0). No complications requiring hospitalization were reported.. The use of antiviral drugs is not consistent among pediatricians. Clear guidelines are needed to minimize the use of drugs and to identify children who are likely to benefit most from antiviral therapy.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Child, Preschool; Community-Acquired Infections; Female; Humans; Italy; Male; Pediatrics; Practice Guidelines as Topic; Surveys and Questionnaires; Time Factors

2002
[Complications and costs associated with chickenpox in immunocompetent children].
    Revista panamericana de salud publica = Pan American journal of public health, 2002, Volume: 12, Issue:2

    Chickenpox is a common infection of childhood in countries that have not included the corresponding vaccination in their immunization schedules. Chickenpox is usually benign in immunocompetent children, and treatment is not needed. The objectives of this study were to investigate the frequency and characteristics of chickenpox complications that require hospital treatment in immunocompetent children and the clinical progression in children of mothers with perinatal chickenpox. In addition, the hospital costs associated with chickenpox in the studied children were calculated.. This was a retrospective study using the clinical records of children with chickenpox hospitalized at the Children's Hospital of Panama, from January 1991 through December 2000. We analyzed the types of complications, the clinical progression, and the hospital costs of the chickenpox patients.. Of 5 203 children seen in outpatient consultations, 568 of them (11%) were hospitalized. We included 513 children in our study: 381 (74%) with chickenpox acquired in the community, 92 (18%) the children of mothers with chickenpox, and 40 (8%) with nosocomial chickenpox. The most frequent complications were cutaneous and subcutaneous infections (45%), respiratory infections (25%), and neurological changes (7%). The respiratory and cutaneous complications occurred sooner and among younger patients than did the neurological changes. Overall, 13 of the children (2.5%) died. The case fatality rate was 8% for chickenpox with respiratory and neurological complications and 0% for chickenpox with cutaneous complications. Of the 92 children with a mother with chickenpox, 60 of them (65%) did not develop the disease, and none of the 92 died. In contrast, 2 of the 32 neonates (6%) with perinatal chickenpox died. The mean length of hospitalization was 8.9 days (standard deviation, +/- 17.4 days). Parenteral pharmacotherapy was used with the great majority of the children, particularly antibiotics (54%), acyclovir (17%), and intravenous immunoglobulin (14%). The mean per-patient cost of hospitalization was US$ 1 209.. Our results show that chickenpox is associated with a sizable number of expensive complications and a not-insignificant case fatality rate in immunocompetent children. Routine vaccination against chickenpox could reduce the impact of this disease on the health of children in Panama

    Topics: Acyclovir; Antiviral Agents; Central Nervous System Diseases; Chickenpox; Child; Child, Preschool; Cost-Benefit Analysis; Female; Hospitalization; Humans; Immunization; Immunocompetence; Immunoglobulins, Intravenous; Infant; Infant Mortality; Infant, Newborn; Male; Maternal Exposure; Respiratory Tract Infections; Retrospective Studies; Skin Diseases

2002
Microbiology. Domino effects from battles against microbes.
    Science (New York, N.Y.), 2002, Oct-11, Volume: 298, Issue:5592

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Controlled Clinical Trials as Topic; Female; Herpes Genitalis; Herpes Zoster; HIV Infections; Humans; Infant; Influenza Vaccines; Influenza, Human; Male; Public Health; Vaccination; Valacyclovir; Valine

2002
Varicella infection following varicella vaccination in a liver transplant recipient.
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2002, Volume: 2, Issue:9

    Varicella infection may result in significant morbidity and mortality in patients who have received an orthotopic liver transplant (OLT). It is unclear if vaccinating these patients against varicella-zoster virus (VZV) infection is safe or effective. We report on a liver transplant recipient with no prior history of VZV infection who was given the varicella vaccine after an indirect VZV exposure. The patient was subsequently hospitalized twice for treatment of cutaneous varicella infection. We will discuss VZV infection, particularly in relation to liver transplantation, and review the prophylaxis and management of VZV infection after OLT.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Female; Humans; Middle Aged

2002
Focal cerebral vasculitis and stroke after chickenpox.
    European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society, 2002, Volume: 6, Issue:6

    Cerebral infarcts are rather rare in children and can be caused by a number of diverse conditions. We report a case of cerebral infarct associated with a recent varicella infection. A 5-year old girl presented with an acute central facial palsy 1 month after a chickenpox infection. The infarction was revealed by magnetic resonance imaging and laboratory studies ruled out all known causes of stroke. Cerebral angiogram demonstrated segmental narrowing and irregularity of the wall of the right internal carotid artery, compatible with focal vasculitis. With the presumed diagnosis of varicella-associated focal angiitis, the patient was treated with high-dose methylprednisolone, acyclovir and aspirin. Magnetic resonance angiogram performed 6 weeks after the stroke demonstrated the resolution of the vasculitis. Varicella infection should be considered one of the possible causes of acute ischaemic strokes in children.

    Topics: Acyclovir; Anti-Inflammatory Agents; Antiviral Agents; Brain; Carotid Arteries; Cerebral Angiography; Chickenpox; Child, Preschool; Female; Humans; Magnetic Resonance Imaging; Methylprednisolone; Stroke; Vasculitis, Central Nervous System

2002
Risk factors and outcome of varicella-zoster virus pneumonia in pregnant women.
    The Journal of infectious diseases, 2002, Feb-15, Volume: 185, Issue:4

    To determine the factors associated with an increased risk of developing varicella-zoster virus (VZV) pneumonia during pregnancy, a case-control analysis was done in which 18 pregnant women with VZV pneumonia were compared with 72 matched control subjects. VZV infection was identified clinically, and VZV pneumonia was diagnosed by dyspnea and findings on chest radiographs. Of 347 pregnant women with VZV infection, 18 (5.2%) had pneumonia treated with acyclovir, and none died. Mean gestational age at rash onset was 25.8 plus minus 8.8 weeks for patients with pneumonia and 17.7 +/- 10.3 weeks for control subjects, which was not significant in the multivariable model. Women with VZV pneumonia were significantly more likely to be current smokers (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.6-16.7) and to have > or = 100 skin lesions (OR, 15.9; 95% CI, 1.9-130.2). Pregnant women with VZV infection may be more likely to develop varicella pneumonia if they are smokers or manifest > or = 100 skin lesions.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Smoking

2002
Chickenpox neuroretinitis in a 9 year old child.
    The British journal of ophthalmology, 2002, Volume: 86, Issue:4

    Topics: Acyclovir; Anti-Inflammatory Agents; Antiviral Agents; Chickenpox; Child; Humans; Male; Prednisolone; Retinitis; Vision Disorders; Visual Acuity

2002
[Varicella during pregnancy].
    Deutsche medizinische Wochenschrift (1946), 2002, Apr-12, Volume: 127, Issue:15

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Contraindications; Female; Humans; Incidence; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Vaccination

2002
Varicella pneumonia in patients with HIV/AIDS.
    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2002, Volume: 6, Issue:1

    To determine the potential role of steroid therapy combined with early antiviral and supportive care in patients infected with human immunodeficiency virus (HIV) with varicella pneumonia.. A retrospective review was conducted of the incidence, clinical course, and outcome of varicella pneumonia in patients with HIV or acquired immunodeficiency syndrome (AIDS).. Seven of 12 patients (58%) who were hospitalized with chickenpox developed clinically severe varicella pneumonia. All patients had advanced immunosuppression and all developed diffuse reticulonodular radiographic abnormalities, although two patients had normal chest radiographs on admission. All patients received antiviral therapy within 12 hours of hospital admission. The overall mortality rate was 43%. Six patients were treated with systemic corticosteroids in addition to antiviral agents, including all four of the survivors.. Hospitalized patients with HIV or AIDS with chickenpox are at high risk for developing varicella pneumonia. There is a potentially high rate of death despite prompt initiation of appropriate antiviral therapy. Intensive care management and adjunctive use of systemic corticosteroids may improve outcome.

    Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; HIV Infections; Hospitalization; Humans; Incidence; Male; Pneumonia, Viral; Retrospective Studies; Survival Rate

2002
Chickenpox oesophagitis and haematemesis in an immunocompetent adult.
    The Journal of infection, 2002, Volume: 44, Issue:3

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Esophagitis; Hematemesis; Herpesvirus 3, Human; Humans; Immunocompetence; Male; Omeprazole

2002
Pretransplant varicella vaccination is cost-effective in pediatric renal transplantation.
    Pediatric transplantation, 2001, Volume: 5, Issue:1

    Because of the severe complications that may result from varicella zoster virus (VZV) infection following renal transplantation (Tx), transplanted varicella-susceptible children exposed to varicella are typically given varicella zoster immunoglobulin (VZIG) as prophylaxis or are admitted and treated with parenteral acyclovir if VZIG prophylaxis fails. As both VZIG and hospitalization are costly, prevention of varicella infection by vaccination could potentially result in significant cost savings in addition to decreasing morbidity and mortality. To test this hypothesis, we developed a decision-analysis model to evaluate the cost-effectiveness of vaccinating patients with chronic renal failure (CRF) against varicella prior to renal transplant. Under baseline assumptions, vaccination for varicella pretransplant was a cost-effective strategy, with a cost of $211 per patient vaccinated compared with $1,828 per patient not vaccinated. The magnitude of cost savings from vaccination was sensitive to variations in the cost of varicella vaccine, the percentage of patients hospitalized for treatment with acyclovir, and the percentage of patients exposed to varicella infection. One- and two-way sensitivity analyses confirmed that vaccination was the dominant cost-effective strategy under all conditions examined. We conclude that vaccination for varicella pretransplant is cost-effective for patients with CRF, and that the magnitude of cost savings is sensitive to the cost of hospitalization, the percentage of patients exposed to varicella, and the cost of varicella vaccination. Pending results of ongoing studies of the safety and efficacy of VZV vaccine in children with CRF, we recommend that VZV vaccine be given to all children with CRF.

    Topics: Acyclovir; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Cost-Benefit Analysis; gamma-Globulins; Herpes Zoster; Humans; Immunization; Kidney Failure, Chronic; Kidney Transplantation

2001
The management of varicella-zoster virus exposure and infection in pregnancy and the newborn period. Australasian Subgroup in Paediatric Infectious Diseases of the Australasian Society for Infectious Diseases.
    The Medical journal of Australia, 2001, Mar-19, Volume: 174, Issue:6

    Zoster immunoglobulin (ZIG) should be offered to pregnant, varicella-seronegative women with significant exposure to varicella-zoster virus (VZV) (chickenpox) infection. Oral aciclovir prophylaxis should be considered for susceptible pregnant women exposed to VZV who did not receive ZIG or have risk factors for severe disease. Intravenous aciclovir should be given to pregnant women who develop complicated varicella at any stage of pregnancy. Counselling on the risk of congenital varicella syndrome is recommended for pregnant women who develop chickenpox. ZIG should be given to a baby whose mother develops chickenpox up to 7 days before delivery or up to 28 days after delivery. Intravenous aciclovir should be given to babies presenting unwell with chickenpox, whether or not they received ZIG. Breastfeeding of babies infected with or exposed to VZV is encouraged. A mother with chickenpox or zoster does not need to be isolated from her own baby. If siblings at home have chickenpox, a newborn baby should be given ZIG if its mother is seronegative. The newborn baby does not need to be isolated from its siblings with chickenpox, whether or not the baby was given ZIG. After significant nursery exposure to VZV, ZIG should be given to seronegative babies and to all babies born before 28 weeks' gestation.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Delivery, Obstetric; Female; Fetal Diseases; Humans; Immunization, Passive; Infant, Newborn; Nurseries, Hospital; Patient Isolation; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications, Infectious

2001
[Benign acute ataxia in an adult with VZV infection].
    Revue neurologique, 2001, Volume: 157, Issue:3

    In adults, neurological complications of VZV virus usually occur after herpes zoster infection in patients with AIDS. We report a case of acute and benign cerebellar ataxia after chickenpox in a patient without immunodeficiency.

    Topics: Acyclovir; Adult; Cerebellar Ataxia; Chickenpox; Encephalitis, Viral; Humans; Male; Neurologic Examination

2001
[Varicella and acyclovir].
    Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 2001, Volume: 8 Suppl 2

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Humans; Immunocompromised Host

2001
Varicella-zoster infection in pediatric solid-organ transplant recipients: a hospital-based study in the prevaricella vaccine era.
    Pediatric transplantation, 2001, Volume: 5, Issue:3

    We reviewed 58 cases of varicella-zoster infection that occurred between 1988 and 1998 in 47 pediatric solid-organ transplant recipients. The median age of patients at the time of admission with varicella-zoster infection was 8.0 yr (range 1-17 yr). The median interval between transplantation (Tx) and varicella-zoster virus (VZV) infection was 1.6 yr (range 0.06-9.3 yr). Varicella infection occurred at a rate of one case for every seven transplant recipients. Among the 58 cases of VZV infection, 53% were varicella while 47% were herpes-zoster. Varicella infection occurred despite treatment with varicella-zoster immune globulin (VZIG) in 17 of 31 cases of varicella infection. However, the disease was generally mild with severe disease occurring in only two patients. One patient (1.7%) died as a result of bacterial sepsis. There was no significant relationship between VZV infection and specific immune suppressants. Episodes of rejection were more likely to be temporally associated with the occurence of herpes zoster than with varicella infection (p = 0.02). The data generated provide useful background information in our population in the prevaricella vaccine era.

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Female; Graft Rejection; Herpes Zoster; Hospitals; Humans; Infant; Male; Nervous System Diseases; Organ Transplantation; Prevalence

2001
[Varicella pneumonia in the adult. Study of 9 cases].
    Anales de medicina interna (Madrid, Spain : 1984), 2001, Volume: 18, Issue:6

    In the adult, the primary infection by the varicella-zoster virus acquires an unusual severity due to several complications, the most frequent of them being pneumonia. We study the main characteristics of nine patients diagnosed of pneumonia varicellosa.. Clinical, therapeutic and evolutive features of 9 adult patients, both immunocompetents and immunodepressed, diagnosed of pneumonia varicellosa are retrospectively reviewed, in the last ten years, at Hospital de Sant Pau, Barcelona. Diagnosis of varicella was established on the basis of the typical rash in the context of a feverish illness. The antecedents of smoking habit, pregnancy and underlying disease, evaluating especially arterial blood and platelet count at entrance, are assessed.. Nine patients (4 males and 5 women; mean age 38 years) were included in the study. Seventy-eight percent of patients were smokers of more than 20 cigarettes a day; one met criteria of simple chronic bronchitis, another suffered ankylosing spondylitis and three were known carriers of human immunodeficiency virus. None of the female patients was pregnant. Respiratory symptoms began from the third and fifth day after the skin rash, and the most common symptoms were cough (89%), dyspnea (67%) and hemoptysis (22%). Arterial blood gas determination showed hypoxemia in four patients (45%). Chest X-ray revealed an interstitial pattern predominantly at both bases, with a case of right pleural effusion. Intravenous acyclovir was started in 6 patients, foscarnet in one and symptomatic therapy in two patients. All patients had a favourable clinical course, none of them requiring entrance to the Intensive Care Unit.. Adult patients with varicella pneumonia that suffer respiratory insufficiency, thrombocytopenia or are carriers of base illnesses must be early treated with intravenous acyclovir. However, despite clinical, biological and radiological recovery is earlier with such treatment, the evolution seems equally favourable if it is only conducted, for instance, symptomatic therapy with antithermic and antihistaminic compounds.

    Topics: Acyclovir; Adult; Age Factors; Antiviral Agents; Chickenpox; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Pneumonia, Viral; Radiography, Thoracic; Tomography, X-Ray Computed

2001
Retinal vasculitis associated with chickenpox.
    American journal of ophthalmology, 2001, Volume: 132, Issue:4

    To report retinal vasculitis in a young, immunocompetent Asian female adult with chickenpox.. Interventional case report. A 32-year-old woman had chickenpox 2 weeks before blurred vision in the left eye. The visual acuity was 20/20 for the right eye and 30/50 for the left eye. The left eye presented keratic precipitates, moderate (2+) cells in the anterior chamber and numerous cells (3+) in the vitreous. The disk was normal. Perivenous exudation was noted mainly in the inferior retina. The sheathed retinal vessels showed late staining but no remarkable leakage on fluorescein angiography. The right eye was normal.. After treatment with acyclovir for 10 days, the visual acuity in the left eye improved to 20/20, and the vasculitis resolved.. Retinal vasculitis may present as a complication of primary varicella infection in an immunocompetent adult.

    Topics: Acyclovir; Adult; Antibodies, Viral; Antiviral Agents; Chickenpox; Female; Fluorescein Angiography; Herpesvirus 3, Human; Humans; Immunocompetence; Retinal Diseases; Retinal Vessels; Vasculitis; Visual Acuity

2001
Outcome of varicella pneumonitis in immunocompetent adults requiring treatment in a high dependency unit.
    The Journal of infection, 2001, Volume: 43, Issue:2

    The incidence of varicella infection is increasing in adults, where primary pneumonitis is the main complication. Little information exists concerning treatment of those patients who require admission to a high dependency unit (HDU) facility. A study was performed to examine the risk factors for developing varicella pneumonitis (VP), to document disease progression and assess prognosis for patients with VP requiring HDU admission.. A 10-year retrospective casenote review of patients admitted to the Regional Infectious Diseases Unit HDU. Varicella pneumonitis (VP) was defined as diffuse nodular shadowing on a chest X-ray (CXR) of a patient with a classical chickenpox rash. Severe pneumonitis was defined as an hypoxaemia index (pO2 in mmHG/FiO2) of less than 150 at any time during hospital stay. All patients were treated with intravenous acyclovir at a dose of 10 mg/kg.. A total of 33 patients were admitted to the HDU with VP over the study period, 30 were included in the study. Annual admission rates remained constant. Most patients (76.7%) had at least one recognised risk factor for severe VP: smoking 18/30, pregnancy 9/30, chronic lung disease 7/30. Twelve (40%) patients had severe VP, eight (26.7%) required assisted ventilation. The presence of greater than one risk factor (p < 0.02) was associated with progression to severe VP. There was one death: a 63-year-old man with a long history of chronic airflow limitation whose treatment had included domicillary long-term oxygen therapy. Nine (30%) patients developed secondary bacterial pneumonia; all recovered with appropriate antibiotic treatment. The period of stay in HDU for the majority of patients was short (mean 4.5 days).. The prognosis for severe adult VP with current available treatment is good. The only predictor on admission for severe VP is the presence of more than one recognised risk factor for developing VP.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Critical Care; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Lung Diseases; Male; Middle Aged; Pneumonia; Pregnancy; Prognosis; Retrospective Studies; Risk Factors; Smoking; Statistics, Nonparametric; Treatment Outcome

2001
Varicella in a pediatric heart transplant population on nonsteroid maintenance immunosuppression.
    Pediatrics, 2001, Volume: 108, Issue:5

    Varicella-zoster virus has been reported to produce serious, often life-threatening, disease in immunosuppressed patients with a variety of diagnoses. The impact of this virus on the young child after heart transplantation has not been reported.. We reviewed the charts of 28 children who were <10 years of age at heart transplantation and had at least 1 year of follow-up. The median follow-up period was 7 years (1.4-13.0 years). All were seronegative for varicella-zoster virus before transplantation. Fourteen (50%) developed varicella at a median time posttransplantation of 3.3 years. The first 7 were admitted for intravenous acyclovir for 3 days followed by oral acyclovir for 7 days. The last 7 were treated as outpatients with oral valacyclovir for 7 days (n = 6) or with oral acyclovir for 10 days (n = 1).. Intravenous and oral regimens both were well tolerated and were without complications. No patient was receiving steroids at the time that they developed their initial episode of varicella. One patient was receiving steroids for therapy of posttransplantation lymphoproliferative disease when she developed recurrent varicella or generalized zoster. No episodes of rejection were attributed to the varicella-zoster virus infection. There were no episodes of localized zoster. All patients experienced seroconversion from undetectable to detectable antibody titers early after varicella, and 12 of the 14 patients continued to have persistent detectable titers in late follow-up. Two of the 14 who received chemotherapy or enhanced immunosuppression after retransplantation transiently lost detectable varicella-zoster virus antibodies but currently have detectable titers.. Primary varicella-zoster infection was well tolerated in our young pediatric heart transplant recipients, with no serious complications. We now reserve inpatient/intravenous therapy for those who are unable to tolerate oral medications or those who are receiving enhanced immunosuppression.

    Topics: Acyclovir; Administration, Oral; Antiviral Agents; Chickenpox; Child; Child, Preschool; Follow-Up Studies; Heart Transplantation; Herpesvirus 3, Human; Humans; Immunocompromised Host; Immunosuppressive Agents; Infant; Infant, Newborn; Injections, Intravenous; Valacyclovir; Valine

2001
[Vesicular rash in a healthy five-month-old baby].
    Enfermedades infecciosas y microbiologia clinica, 2001, Volume: 19, Issue:9

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Fetal Diseases; Genital Diseases, Male; Gestational Age; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Male; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications, Infectious; Virus Cultivation

2001
Incidence, risk factors and outcome of varicella-zoster virus infection in children after haematopoietic stem cell transplantation.
    Bone marrow transplantation, 2000, Volume: 25, Issue:2

    We report a retrospective analysis of VZV infection after haematopoietic stem cell transplantation (HSCT) in children. Thirty-three (30%) of the total 109 children who were transplanted during a 7 year period developed post-transplant VZV infection. Twenty-four of these 33 (73%) children had VZV infection within 1 year following HSCT. The cumulative incidences of post-transplant VZV infection at 1 and 5 years were 26% and 45%, respectively. The positive and negative predictive values of pretransplant VZV serology in recipients on the development of HZ following HSCT were 39% and 88%, respectively. Pretransplant VZV seropositivity in recipients was the only risk factor for post-transplant herpes zoster (HZ) infection on multivariate analysis. All patients responded to acyclovir. The median duration of VZV infection was 5 days. Three (11%) and one (3%) children with HZ developed visceral dissemination and post-herpetic neuralgia, respectively. No mortality was directly attributed to VZV infection. VZV infection remains a major cause of morbidity in children after HSCT. Further studies are warranted to evaluate the potential use of VZV vaccine in these children. Bone Marrow Transplantation (2000) 25, 167-172.

    Topics: Acyclovir; Adolescent; Adult; Antibodies, Viral; Antiviral Agents; Blood Transfusion, Autologous; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunosuppression Therapy; Incidence; Infant; Infant, Newborn; Retrospective Studies; Risk Factors; Treatment Outcome

2000
Characterization of acyclovir susceptibility and genetic stability of varicella-zoster viruses isolated during acyclovir therapy.
    Journal of dermatological science, 2000, Volume: 23, Issue:1

    We have characterized the susceptibility and genetic stability of varicella-zoster viruses (VZV) isolated from skin lesions of three patients with herpes zoster and six patients with varicella treated with conventional short-term acyclovir (ACV) administration. The susceptibilities to ACV of the serial isolates from the patients were examined, and there was no significant difference in the susceptibility to ACV among the isolates before and during the ACV treatment, indicating that conventional short-term ACV treatment did not generate ACV-resistant VZV infections. Polymerase chain reaction (PCR) analyses of these as well as seven thymidine kinase-deficient VZV strains derived from in vitro ACV treatment were carried out to examine their genomic stability. Five regions containing tandem direct reiterations (R1-R5) were amplified by PCR and compared, and the region containing the Pst I-site was also examined. PCR analyses demonstrated that the R1, R5 and the Pst I-sites were stable and useful in epidemiological studies even after ACV treatment. The R2, R3 and R4 sites were far less stable in these experimental conditions. In this paper we discuss the results of the PCR analyses with regard to the dynamics of VZV population in patients with VZV infection treated with conventional short-term ACV administration.

    Topics: Acyclovir; Aged; Antiviral Agents; Base Sequence; Chickenpox; Child, Preschool; DNA, Viral; Drug Resistance, Microbial; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Male; Molecular Epidemiology; Polymerase Chain Reaction; Skin; Thymidine Kinase

2000
A rapid phenotypic assay for detection of acyclovir-resistant varicella-zoster virus with mutations in the thymidine kinase open reading frame.
    Antimicrobial agents and chemotherapy, 2000, Volume: 44, Issue:4

    Susceptibility assays by cell culture methods are time-consuming and are particularly difficult to perform with varicella-zoster virus (VZV). To overcome this limitation, we have adapted a functional test of the viral thymidine kinase (TK) in TK-deficient (tdk mutant) bacteria to detect ACV-resistant VZV in clinical samples. After PCR amplification, the complete viral TK open reading frame (ORF) is purified from PCR primers, digested with two restriction enzymes, and ligated in an oriented fashion into a bacterial expression vector. The ligation products are then used to transform tdk mutant bacteria. After transformation, an aliquot of the bacteria is plated onto a plate with minimal medium containing (i) ampicillin to select for plasmids carrying the viral TK ORF and (ii) isopropyl beta-D-thiogalactopyranoside (IPTG) to induce its expression. An identical aliquot of bacteria is also plated onto a medium containing, in addition to the components described above, 5-fluorodeoxyuridine (FUdR). Compared to the number of transformants on FUdR-free medium, the number of colonies carrying TK derived from susceptible strains was reduced by 86%, on average, in the presence of FUdR. In contrast, the number of transformants carrying TK from resistant strains with a mutant TK were reduced by only 4%, on average, on FUdR-containing plates. We have assessed the validity of this assay with cell culture isolates and several clinical samples including two cerebrospinal fluid samples from which no virus could be isolated. This colony reduction assay allowed the correct identification of the TK phenotype of each VZV isolate tested and can be completed within 3 days of receipt of the sample.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Cloning, Molecular; Escherichia coli; Floxuridine; Herpesvirus 3, Human; Humans; Mutation; Open Reading Frames; Phenotype; Reverse Transcriptase Polymerase Chain Reaction; Thymidine Kinase

2000
[Varicella pneumonia].
    Schweizerische medizinische Wochenschrift, 2000, Mar-18, Volume: 130, Issue:11

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Herpesvirus 3, Human; Humans; Immunologic Deficiency Syndromes; Male; Pneumonia, Viral; Radiography

2000
Comparison of quantitations of viral load in varicella and zoster.
    Journal of clinical microbiology, 2000, Volume: 38, Issue:6

    The pathogenesis of varicella and zoster and the effects of antiviral treatment were investigated using real-time PCR for varicella-zoster virus (VZV) DNA in skin lesions and peripheral blood. A higher occurrence of viremic VZV DNA was observed in varicella than in zoster. Acyclovir treatment resulted in marked suppression of viremia in varicella.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Humans; Infant; Skin; Viral Load

2000
Donor organ transmission of varicella zoster due to cardiac transplantation.
    Transplantation, 2000, Jul-15, Volume: 70, Issue:1

    We report a case of donor-transmitted varicella zoster viral (VZV) infection in a cardiac transplant recipient. A 15-month-old girl developed primary VZV infection 12 days after cardiac transplantation. The donor suffered from varicella 2 weeks before death from pneumococcal meningitis.. Despite treatment of the seronegative recipient with intravenous acyclovir from the time of surgery, she developed symptoms of fever, a nonspecific macular rash, and small palatal vesicles.. After rapid diagnostic confirmation by direct immunofluorescence on vesicular fluid, high-dose intravenous acyclovir was commenced. In addition, the cyclosporine dose was reduced by 25%. The child made a quick and uncomplicated recovery.. Donor organ transmission of VZV has not, to our knowledge, been previously reported. It occurred despite treatment with acyclovir and resulted in an atypical cutaneous eruption. It responded to an increased dose of acyclovir and a reduced level of immunosuppression.

    Topics: Acyclovir; Chickenpox; Female; Heart Transplantation; Humans; Infant; Tissue Donors

2000
[Varicella and pregnancy. A case report].
    La Revue de medecine interne, 2000, Volume: 21, Issue:8

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Pregnancy; Pregnancy Complications, Infectious

2000
[Chicken pox recurrence revealing a renal adenocarcinoma in an adult].
    Annales de medecine interne, 2000, Volume: 151, Issue:5

    A new episode of chicken pox in adults who had a well documented infection previously is usually observed in immunocompromised individuals. The principal immunodeficiency factors are hematology diseases, acquired immunodeficiency disease and old age. We report here the case of a young woman who after a contaminating contact presented a recurrence of typical chicken pox. Morphological investigations evidenced a right kidney tumor which pathology revealed to be a renal adenocarcinoma. We discuss this pathological association and review cases reported in the literature.

    Topics: Acyclovir; Adenocarcinoma, Clear Cell; Adult; Antiviral Agents; Chickenpox; Female; Humans; Immunocompromised Host; Kidney Neoplasms; Nephrectomy; Recurrence; Tomography, X-Ray Computed

2000
Acyclovir prophylaxis of varicella in children with nephrotic syndrome.
    Pediatric nephrology (Berlin, Germany), 2000, Volume: 15, Issue:3-4

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child, Preschool; Female; Humans; Male; Nephrotic Syndrome

2000
Acyclovir-resistant varicella infection with atypical lesions in a non-HIV leukemic infant.
    Acta paediatrica (Oslo, Norway : 1992), 2000, Volume: 89, Issue:12

    An HIV-negative infant presented with VZV primary infection during the maintenance therapy for megakaryoblastic leukaemia. The lesions were initially vesicular and necrotic but became verrucous and hyperkeratotic. A clinical resistance to acyclovir was suspected and confirmed by histologic and virologic studies. The patient was successfully treated by foscarnet.. resistance of VZV to acyclovir may occur after a short treatment in a non-AIDS patient.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Drug Resistance; Foscarnet; Herpesvirus 3, Human; HIV Seronegativity; Humans; Infant; Leukemia, Megakaryoblastic, Acute; Male; Microbial Sensitivity Tests; Regression Analysis

2000
[Varicella pneumonia in the adult: study of 22 cases].
    Enfermedades infecciosas y microbiologia clinica, 2000, Volume: 18, Issue:10

    Retrospective study of the varicella pneumonia in adults with clinical, therapeutic and evolutive features in 22 patients in the last 5 years.. The diagnosis was established by clinical and radiologic criteria in the course of varicella infection. The antecedents of pregnancy, smoking habit, previous contact with patients with varicella and underlying disease were evaluated.. Twenty-two patients (14 males and 8 women: mean age 31 years. range: 22-40) were included in the study. None of them were immunocompromised, 16 (72.7%) have had previous contact with varicella patients. 19 (86.3%) were heavy smokers and none of the female patients was pregnant. All patients had fever and exanthem, cough had 20 (90.9%) dyspnea 16 (72.7%), chest pain 9 (40.9%) and hemoptysis 5 (22.7%). Only two patients showed pO2 < 60 mmHg. Chest X-ray revealed an interstitial pattern in 14 cases (63.3%), and micronodular in 8 (36.3%). All patients received treatment with intravenous acyclovir. Three patients (13.6%) were admitted to the Intensive Care Unit due to respiratory insufficiency, needing mechanical ventilation one of them (4.5%). Another three developed failure renal reversible associated with acyclovir. All patients had a favourable clinical course.. We believe, that early, aggressive use of intravenous acyclovir in adult varicella pneumonia may be lifesaving, preventing progressive respiratory failure and reducing the high mortality rate of the disease. Therapy with corticosteroids should be considered in addition to antiviral therapy in patients with severe varicella pneumonia. While oral acyclovir chemoprophylaxis is probably beneficial in populations with chicken pox.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Male; Pneumonia, Viral; Retrospective Studies

2000
Acute retinal necrosis syndrome complicating chickenpox.
    Singapore medical journal, 2000, Volume: 41, Issue:12

    Chickenpox may be complicated by ocular involvement. In these patents, acute retinal necrosis usually forms a relatively mild course. Systemic antiviral treatment during the acute phase of the disease is recommended. Rarely, retinal detachment may develop, resulting in blindness. It is strongly recommended that patients with chickenpox who develop visual symptoms should be referred for an ophthalmological opinion early.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Child, Preschool; Follow-Up Studies; Humans; Infusions, Intravenous; Male; Retinal Necrosis Syndrome, Acute; Treatment Outcome; Visual Acuity

2000
Neonatal varicella and acyclovir.
    Saudi medical journal, 2000, Volume: 21, Issue:7

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Gestational Age; Humans; Immune Sera; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious

2000
[Varicella pneumonia in the previously healthy adult].
    Anales de medicina interna (Madrid, Spain : 1984), 1999, Volume: 16, Issue:2

    Varicella (chickenpox) is a contagious, self-limited, usually benign disease common in childhood but uncommon in adulthood. Pneumonia is the most frequent complication of the disease in adults. We retrospectively review 7 cases of varicella pneumonia in previously healthy adults diagnosed in our hospital between 1992 and 1996. All of them were treated with intravenous acyclovir with good therapeutic response save for a patient who developed respiratory insufficiency and died 8 days after his admission. Smoking was the only risk factor detected. Clinical features of our patients are described and the need of an early diagnosis and treatment of varicella pneumonia is emphasized.

    Topics: Acyclovir; Adult; Anti-Bacterial Agents; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Female; Humans; Male; Pneumonia, Viral; Retrospective Studies

1999
[Recommendations for the use of the varicella vaccine in immunosuppressed patients].
    Anales espanoles de pediatria, 1999, Volume: 50, Issue:2

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Humans; Immunization Schedule; Immunocompromised Host; Infant

1999
[Pneumonitis associated with primary infection by varicella-zoster virus: apropos of 11 cases].
    Anales de medicina interna (Madrid, Spain : 1984), 1999, Volume: 16, Issue:4

    Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Chickenpox; Child; Female; HIV Seropositivity; Humans; Male; Pneumonia, Viral; Risk Factors; Seasons; Smoking

1999
Prophylactic or therapeutic intervention for varicella zoster in tropical countries?
    Tropical medicine & international health : TM & IH, 1999, Volume: 4, Issue:4

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Developing Countries; Drug Storage; Humans; Tropical Climate; Vaccination

1999
Neonatal varicella: varicella zoster immunoglobulin (VZIG) does not prevent disease.
    Archives of disease in childhood. Fetal and neonatal edition, 1999, Volume: 81, Issue:1

    Two infants with severe varicella are reported. They received varicella zoster immunoglobulin (VZIG) without concurrent information to parents or carers regarding further care. In both these cases there was a three day delay between the onset of symptoms and initiation of aciclovir. This delay was due to lack of awareness of the high risk of varicella in these infants. Infants born to mothers with onset of chickenpox 4 days before to 2 days after delivery are at risk of fatal varicella, despite the use of VZIG prophylaxis.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Humans; Immune Sera; Infant, Newborn; Male; Risk Factors; Time Factors

1999
Varicella-zoster virus-specific cellular immunity in subjects given acyclovir after household chickenpox exposure.
    The Journal of infectious diseases, 1999, Volume: 180, Issue:3

    The time course of primary cell-mediated immune responses to varicella-zoster virus (VZV) among persons receiving acyclovir prophylaxis after exposure to chickenpox has not been well defined. Fifteen children who had household exposure to varicella received prophylactic acyclovir (40 mg/kg/day for 7-14 days after exposure) and were studied for development of both antibody and cell-mediated immunity (CMI) to VZV. Twelve developed antibodies and/or CMI; 10 had no symptoms and 2 manifested mild varicella. Two were already immune to varicella and had booster immune responses. One was not infected and subsequently developed full-blown varicella. Although acyclovir given after exposure to VZV is highly effective and does not appear to attenuate the immune response, it remains necessary to confirm whether, in the absence of clinical varicella, persons acquire specific immunity.

    Topics: Acyclovir; Antibodies, Viral; Antibody Formation; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child, Preschool; Community-Acquired Infections; Family; Female; Herpesvirus 3, Human; Humans; Immunity, Cellular; Immunization, Secondary; Infant; Male; Time Factors

1999
[Congenital neonatal varicella with systemic involvement].
    Anales espanoles de pediatria, 1999, Volume: 51, Issue:2

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Diagnosis, Differential; Female; Fetal Diseases; Herpesvirus 3, Human; Humans; Infant, Newborn; Male; Pregnancy

1999
Chickenpox in four adult renal transplant recipients.
    Transplantation proceedings, 1999, Volume: 31, Issue:6

    Topics: Acyclovir; Adult; Aged; Antiviral Agents; Chickenpox; Female; Humans; Kidney Transplantation; Male; Middle Aged; Postoperative Complications; Retrospective Studies

1999
Acyclovir treatment prevents varicella-zoster virus replication in PBMC during viremia.
    The new microbiologica, 1999, Volume: 22, Issue:4

    The most effective antiviral therapy of varicella and zoster has become acyclovir. Using polymerase chain reaction specific for VZV ORF 14, ORF 29, ORF 63 as well as nucleic acid sequence-based amplification (ORF 63, ORF 68) we tested PBMC of patients with VZV-associated diseases for the presence of viral DNA and RNA, respectively. In PBMC of patients treated with acyclovir neither DNA nor RNA was detectable already one day after the onset of therapy. In three blood sample pairs from zoster patients we were able to detect viral nucleic acid before but not after acyclovir treatment. These results confirm clinical and epidemiological data. It can be concluded that treatment with acyclovir prevents VZV replication in peripheral blood mononuclear cells.

    Topics: Acyclovir; Adult; Aged; Antiviral Agents; Chickenpox; Child; DNA, Viral; Herpes Zoster; Herpesvirus 3, Human; Humans; Leukocytes, Mononuclear; Middle Aged; RNA, Viral; Viremia; Virus Replication

1999
Neonatal varicella: a report of 26 cases.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 1999, Volume: 82, Issue:10

    Varicella infection usually occurs in childhood and is uncommon in neonates. We reported 26 cases of neonatal varicella seen at the Queen Sirikit National Institute of Child Health, Bangkok, from 1988 to 1995. The sex ratio of male to female was equal. The age of onset was between 6 to 27 days. Twelve cases contracted varicella from mothers who were infected between 6 days before delivery to 2 days after delivery (perinatal varicella) and fourteen cases contracted varicella from mothers or siblings in the postnatal period (postnatal varicella). All babies developed vesicular rash. Intravenous acyclovir was given in high risk and severe cases (nine perinatal and three postnatal varicella patients). Complications of neonatal varicella included clinical sepsis 8 cases (30%), pneumonia 7 cases (26%), pyoderma 9 cases (35%) and hepatitis 1 case (4%). There was no statistical difference between the complications of perinatal and postnatal group (p > 0.05). No death was observed during this study. Clinical manifestations of neonatal varicella varied from mild to severe, depending on the onset of rash in the mother and baby and mode of transmission of the disease. Although we have no varicella-zoster immunoglobulin (VZIG), acyclovir therapy is beneficial in the treatment of neonatal varicella.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Disease Transmission, Infectious; Female; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Retrospective Studies

1999
An immunocompetent child with herpes zoster following post-exposure prophylaxis of varicella by oral acyclovir.
    Acta paediatrica (Oslo, Norway : 1992), 1999, Volume: 88, Issue:10

    Topics: Acyclovir; Administration, Oral; Antiviral Agents; Chickenpox; Herpes Zoster; Humans; Immunity, Cellular; Immunocompetence; Infant; Male

1999
[Residual changes after varicella pneumonia].
    Schweizerische medizinische Wochenschrift, 1999, Dec-18, Volume: 129, Issue:50

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Lung; Pneumonia, Viral; Radiography

1999
Adult varicella pneumonia that responded to combined acyclovir and steroid therapy.
    The Medical journal of Malaysia, 1999, Volume: 54, Issue:2

    We describe a case of adult chickenpox which was complicated by severe varicella pneumonia, mild hepatitis and thrombocytopenia. The hepatitis and the thrombocytopenia were asymptomatic clinically and were diagnosed on biochemistry and blood count results. These eventually improved without specific interventions. The pneumonia, however, deteriorated rapidly despite the early commencement of oxygen supplementation, acyclovir and antibiotic. Subsequently, systemic corticosteroid therapy was initiated and the patient was ventilated in the intensive care unit. The patient eventually recovered.

    Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Humans; Male; Pneumonia, Viral

1999
Cost effectiveness of early treatment with oral aciclovir in adult chickenpox.
    PharmacoEconomics, 1998, Volume: 13, Issue:5 Pt 2

    Treatment of adult chickenpox with aciclovir is controversial because of the relatively high cost of medication and small proven benefits of therapy. A decision-tree model was used to estimate the cost effectiveness of aciclovir, from third-party payer and societal perspectives: the incremental cost per quality-adjusted life-year (QALY) gained was calculated for aciclovir treatment of chickenpox compared with no antiviral therapy in immunocompetent adults who presented within 24 hours of the onset of chickenpox rash. Incremental costs for aciclovir compared with no antiviral treatment were 42,900 US dollars per QALY gained, when viewed from a third-party payer perspective; however, results are sensitive to variation of clinical parameters. From a societal perspective, aciclovir therapy was cost saving compared with no antiviral treatment; aciclovir remained cost saving or cost effective (less than 50,000 US dollars per QALY gained) when probabilities, quality-of-life utility values and costs were varied within clinically plausible ranges, and when other scenarios for chickenpox severity and aciclovir effectiveness were examined. From a societal perspective, oral aciclovir is cost effective, and perhaps cost saving, when given within 24 hours of rash onset in adult chickenpox. The argument for antiviral use may be less strong when viewed from the perspective of a third-party payer.

    Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Chickenpox; Cost-Benefit Analysis; Humans; Quality of Life; Quality-Adjusted Life Years

1998
Persistence of protective immunity after postexposure prophylaxis of varicella with oral aciclovir in the family setting.
    Archives of disease in childhood, 1998, Volume: 78, Issue:1

    The persistence of protective immunity after postexposure prophylaxis against varicella using oral aciclovir was evaluated in the family setting. Sixty one of 78 recipients of oral aciclovir were assessed by questionnaire, and 13 of 61 were evaluated for serum antibody to varicella zoster virus (VZV) using the fluorescent antibody to membrane antigen method. The observation period ranged from 33 to 50 months. None of those (n = 44) who had initially seroconverted to VZV after aciclovir prophylaxis developed breakthrough varicella. All 13 who had serology repeated still had titres > or = 4. Antibody titres in those who had histories of re-exposure to the virus were significantly higher than in those who had not (p < 0.01).

    Topics: Acyclovir; Antibodies, Viral; Antiviral Agents; Chickenpox; Child; Child, Preschool; Family Health; Female; Follow-Up Studies; Herpesvirus 3, Human; Humans; Infant; Male

1998
Susceptibilities to aciclovir in viral isolates from children with varicella.
    Archives of disease in childhood, 1998, Volume: 78, Issue:1

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child, Preschool; Female; Herpesvirus 3, Human; Humans; Infant; Male

1998
Acyclovir and related compounds.
    The Pediatric infectious disease journal, 1998, Volume: 17, Issue:3

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Humans

1998
Recurrent varicella pneumonia complicating an endogenous reactivation of chickenpox in an HIV-infected adult patient.
    The European respiratory journal, 1998, Volume: 11, Issue:3

    We report the case of an adult patient with acquired immune deficiency syndrome (AIDS) presenting with acute dyspnoea and cutaneous disseminated lesions suggestive of an atypical varicella. The chest radiograph and the computed tomography (CT)-scan revealed a miliary pneumonia. On a previous serum sample varicella-zoster (VZV)-specific serum immunoglobulin (Ig)G titre was 1/200. A high dose acyclovir treatment was effective, but recurrences occurred twice when the treatment was discontinued. During the first recurrence the polymerase chain reaction (PCR) detected the presence of VZV in the bronchoalveolar lavage (BAL) sample. These findings confirmed the diagnosis of secondary varicella with pulmonary involvement. Secondary varicella pneumonia has not been reported in a human immunodeficiency virus (HIV)-infected adult until now. The use of PCR on a BAL sample was very useful in this case because viral culture remained negative. Recurrences of the varicella pneumonia suggested that a maintenance treatment was required in this deeply immunocompromised patient.

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Antiviral Agents; Bronchoalveolar Lavage Fluid; Chickenpox; Herpesvirus 3, Human; Humans; Male; Pneumonia, Viral; Polymerase Chain Reaction; Recurrence

1998
[Two cases of severe adult varicella pneumonia].
    Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society, 1998, Volume: 36, Issue:3

    Varicella pneumonia is the most common complication of adult varicella. Symptoms may be severe and the mortality rate high in patients who are immunodeficient or pregnant. Symptoms may be mild and progression more favorable in adults previously in good health. We report two cases of varicella infection complicated by severe pulmonary involvement in adult patients who were previously healthy. Case 1 was a 36-year-old male who 6 days after developing varicella was clinically observed to have dyspnea and hemopytsis. He died of acute respiratory failure on the following day. Case 2 was a 28-year-old male whose respiratory symptoms started the third day after developing varicella. These symptoms were relieved by treatment with acyclovir and gammaglobulin. Careful observation is and an early treatment of varicella should be undertaken not only for patients with suppressed cellular immunity, but also for healthy adults, to prevent severe complications.

    Topics: Acute Disease; Acyclovir; Adult; Antiviral Agents; Chickenpox; gamma-Globulins; Hemoptysis; Humans; Male; Pneumonia, Viral; Respiratory Insufficiency

1998
[A case of severe respiratory failure due to varicella pneumonia].
    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine, 1998, Jun-10, Volume: 87, Issue:6

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Immunoglobulins; Methylprednisolone; Pneumonia, Viral; Respiratory Insufficiency

1998
Corticosteroids in life-threatening varicella pneumonia.
    Chest, 1998, Volume: 114, Issue:2

    Varicella pneumonia that results in respiratory failure or progresses to the institution of mechanical ventilation carries a significant morbidity and mortality despite intensive respiratory support and antiviral therapy. There has been no reported study of the role of corticosteroids in life-threatening varicella pneumonia.. This was an uncontrolled retrospective and prospective study of all adult patients with a diagnosis of varicella pneumonia who were admitted to the ICUs of the Johannesburg group of academic hospitals in South Africa between 1980 and 1996. Patient demographics, clinical and laboratory features, necessity for mechanical ventilation, and complications were reviewed. The outcome and therapy of varicella pneumonia was evaluated with particular reference to the use of corticosteroids. Patients with comorbid disease and those already taking immunosuppressive agents were excluded. Key endpoints included length of ICU and hospital stay and mortality.. Fifteen adult patients were evaluated, six of whom received corticosteroids in addition to antiviral and supportive therapy. These six patients demonstrated a clinically significant therapeutic response. They had significantly shorter hospital (median difference, 10 days; p<0.006) and ICU (median difference, 8 days; p=0.008) stays and there was no mortality, despite the fact that they were admitted to the ICU with significantly lower median ratios between PaO2 and fraction of inspired oxygen than those patients (n=9) who did not receive corticosteroid therapy (86.5 vs 129.5; p=0.045).. When used in addition to appropriate supportive care and early institution of antiviral therapy, corticosteroids appear to be of value in the treatment of previously well patients with life-threatening varicella pneumonia. The observations presented in this study are important and should form the basis for a randomized controlled trial, as no other relevant studies or guidelines are available.

    Topics: Acyclovir; Adult; Antiviral Agents; Blood Gas Analysis; Chickenpox; Drug Therapy, Combination; Female; Glucocorticoids; Herpesvirus 3, Human; Humans; Male; Middle Aged; Pneumonia, Viral; Prospective Studies; Radiography; Respiration, Artificial; Retrospective Studies; Treatment Outcome

1998
[Antiviral treatment of Varicella zoster virus infection].
    Ugeskrift for laeger, 1998, Nov-23, Volume: 160, Issue:48

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Herpes Zoster; Humans

1998
Diagnostic case study: varicella pneumonia.
    Seminars in respiratory infections, 1998, Volume: 13, Issue:4

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Treatment Outcome

1998
Topical foscarnet for aciclovir-resistant mucocutaneous herpes infections in AIDS.
    AIDS (London, England), 1997, Volume: 11, Issue:2

    Topics: Acyclovir; Administration, Topical; Antiviral Agents; Chickenpox; Drug Resistance, Microbial; Foscarnet; Herpes Simplex; Herpesvirus 3, Human; Humans; Simplexvirus

1997
A continuous infusion of acyclovir for severe hemorrhagic varicella.
    The New England journal of medicine, 1997, Mar-06, Volume: 336, Issue:10

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Hemorrhage; Humans; Infusions, Intravenous; Leukemia

1997
Oral acyclovir therapy for varicella in pregnancy.
    International journal of dermatology, 1997, Volume: 36, Issue:1

    Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Chickenpox; Contraindications; Female; Herpesvirus 3, Human; Humans; Pregnancy; Pregnancy Complications, Infectious

1997
[Syndrome of fetal varicella secondary to maternal varicella in the 26th week of gestation].
    Anales espanoles de pediatria, 1997, Volume: 46, Issue:1

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Female; Fetal Diseases; Herpesvirus 3, Human; Humans; Infant, Newborn; Maternal-Fetal Exchange; Pregnancy

1997
Musculoskeletal side-effects of varicella.
    Lancet (London, England), 1997, Mar-22, Volume: 349, Issue:9055

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Fasciitis, Necrotizing; Humans; Musculoskeletal Diseases; Shock, Septic; Streptococcal Infections; Streptococcus pyogenes; Vaccination

1997
Intensive care management of varicella pneumonia.
    Respiratory medicine, 1997, Volume: 91, Issue:4

    To determine the clinical features, treatment and outcome of severe varicella pneumonia with hypoxic respiratory failure requiring intensive care management, a prospective survey of consecutive cases was undertaken. Fifteen consecutive adult cases of varicella pneumonia with respiratory failure admitted to a 10-bed respiratory intensive care unit over a period of 10 y from 1984-1993 were studied. All patients were given acyclovir immediately on admission. The level of ventilatory support needed was determined by the severity of gas exchange abnormality, and varied from face mask oxygen (three patients), through continuous positive airway pressure (CPAP) by face mask (eight patients), to continuous positive pressure ventilation (CPPV) (four patients). The majority of patients were young females, only one of whom was pregnant. All patients had been in close contact with a known case of chickenpox. All patients responded well to acyclovir and ventilatory support with improved oxygenation. Monitoring with pulse oximetry was important to detect episodes of desaturation on inadvertent discontinuation of positive and expiratory pressure (PEEP). Two patients were admitted with bacterial superinfection, and one patient, who had required intubation and CPPV, developed nosocomial respiratory tract infection. There were no deaths. This experience suggests that intensive care admission, with the early administration of intravenous acyclovir and recognition of the severity of the hypoxaemia resulting from varicella pneumonia (which can be reversed with PEEP), should reduce the mortality of severe varicella pneumonia in adults.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Critical Care; Female; Humans; Male; Middle Aged; Pneumonia, Viral; Positive-Pressure Respiration; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies

1997
Acyclovir therapy for immunocompetent children with chickenpox. Acyclovir-chickenpox Italian Study Group.
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1997, Volume: 24, Issue:6

    Topics: Acyclovir; Adolescent; Antiviral Agents; Chickenpox; Child; Child, Preschool; Female; Humans; Infant; Male

1997
Prolonged extracorporeal life support (ECLS) for varicella pneumonia.
    Critical care medicine, 1997, Volume: 25, Issue:6

    To review the institutional experience of a national tertiary referral center for extracorporeal life support (ECLS) in severe varicella pneumonia.. Hospital records and ECLS flow sheets.. All pediatric (nonneonatal) and adult patients who were treated for varicella pneumonia with ECLS at the University of Michigan Medical Center between 1986 and 1995.. Diagnosis of varicella pneumonia was made by history of recent exposure to chickenpox, progressive dyspnea, fever, a characteristic diffuse, vesicular rash, and a supporting chest roentgenogram. Indications for ECLS included a shunt fraction of > 30% or PaO2/FlO2 ratio of < 80 despite maximal conventional therapy, which included aggressive diuresis, blood transfusions to optimize oxygen-carrying capacity, pressure-controlled/inverse-ratio ventilation, and intermittent prone positioning.. Between 1986 and 1995, 191 patients were referred for ECLS. Among these patients, there were 51 (27%) cases of viral pneumonia, of which nine cases were due to acute varicella-zoster infection. Intravenous acyclovir was administered to eight of the nine patients. Of the nine patients, two patients improved using conventional ventilator management, and seven patients underwent ECLS. Overall survival on ECLS was 71% (5/7). The mean (+/-SD) alveolar-arterial oxygen gradient and PaO2/FlO2 ratio were 533 +/- 101 torr (71.3 +/- 13.5 kPa) and 67 +/- 24, respectively. The median duration of mechanical ventilation before ECLS and the subsequent duration of ECLS were 4 and 12.8 days, respectively. One of the deaths was from progressive right heart failure secondary to pulmonary hypertension and the other death was from overwhelming Pseudomonas sepsis.. Early recognition of imminent pulmonary failure and rapid institution of ECLS are critical in the successful management of severe, life-threatening varicella pneumonia.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Child; Child, Preschool; Extracorporeal Membrane Oxygenation; Female; Humans; Male; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious

1997
More on continuous-infusion acyclovir for severe varicella.
    The New England journal of medicine, 1997, Jul-17, Volume: 337, Issue:3

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Humans; Infusions, Intravenous

1997
Recurrence of chickenpox in an acyclovir-treated patient.
    Journal of paediatrics and child health, 1997, Volume: 33, Issue:3

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Humans; Male; Recurrence

1997
Management of varicella infection during the course of inflammatory bowel disease.
    The American journal of gastroenterology, 1997, Volume: 92, Issue:9

    To study the natural history and outcome of varicella infection developing in steroid treated inflammatory bowel disease.. Varicella infection occurring in immunosuppressed or immunocompromised patients is a common problem with a significant mortality. Varicella infection during the course of inflammatory bowel disease has been reported in a small number of patients with at least one fatality.. Four young patients with inflammatory bowel disease who developed varicella infection while on immunosuppressive therapy, steroids, or azathioprine were studied. In each patient the infection was severe, and the three most recently treated patients received acyclovir.. All four patients developed severe varicella infection while receiving immunosuppressive therapy for their disease. Three patients were treated with intravenous acyclovir with concomitant reduction of steroid dosage and recovered completely. One patient, treated in 1980 with antibiotics and reduction in steroids, did not receive acyclovir and also survived.. Varicella infection is a relatively uncommon occurrence in inflammatory bowel disease. If varicella infection occurs, prompt diagnosis and treatment with acyclovir and concomitant reduction in immunosuppressive therapy (reduction in steroid dosage and discontinuation of azathioprine) should be initiated immediately to limit viremia and avoid fatal complications.

    Topics: Acyclovir; Adult; Anti-Inflammatory Agents; Antiviral Agents; Azathioprine; Cause of Death; Cephalexin; Cephalosporins; Chickenpox; Child; Colectomy; Colitis, Ulcerative; Crohn Disease; Female; Glucocorticoids; Humans; Immunocompromised Host; Immunosuppressive Agents; Inflammatory Bowel Diseases; Injections, Intravenous; Male; Megacolon, Toxic; Methylprednisolone; Prednisone; Rectum; Remission Induction; Treatment Outcome

1997
Acyclovir therapy in a steroid recipient with varicella.
    The Pediatric infectious disease journal, 1997, Volume: 16, Issue:11

    Topics: Acyclovir; Adrenal Cortex Hormones; Antiviral Agents; Chickenpox; Child; Female; Humans; Hypopituitarism; Immune Tolerance

1997
[Varicella pneumonia in the adult. A review of 25 cases].
    Revista clinica espanola, 1997, Volume: 197, Issue:10

    To study the clinical, therapeutic, and evolutive features in 25 patients with the diagnosis of varicella pneumonia (VP) in the last 15 years.. The diagnosis was established by clinical and radiologic criteria in the course of varicella infection. The antecedents of smoking habit, pregnancy, and underlying disease were evaluated. Hypoxemia was defined as a pO2 < or = 65 mmHg with a FiO2 of 0.21.. Twenty-five patients (16 males and 9 women; mean age 31.5 years, range: 24-43 years) were included in the study. Ninety-two percent of patients were smokers of more than 20 cigarettes a day; five met criteria of simple chronic bronchitis, 3 were known carriers of human immunodeficiency virus (HIV) and one had a chronic liver disease caused by hepatitis C virus. In 16 patients (64%) there were no underlying diseases and none of the female patients was pregnant. Respiratory symptoms began from the first and seventh day after the skin rash, and the most common symptoms were cough (76%), dyspnea (48%), and chest pain (44%). In 22 patients an arterial gas determination was obtained and hypoxemia was documented in 8 patients (32%). Hypoxemia was greater and statistically significant in patients with underlying diseases (p < 0.01). Chest X-ray revealed an interstitial pattern predominantly at both bases. Intravenous acyclovir therapy was started in 19 patients (76%) with severe respiratory symptoms and/or underlying disease. Three patients (12%) were admitted to the Intensive Care Unit for mechanical ventilation. All patients had a favourable clinical course.. Adult patients with symptoms of VP had a favourable clinical course with intravenous acyclovir, and the presence of hypoxemia was more commonly observed when underlying diseases were also present.

    Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Chickenpox; Female; HIV-1; Humans; Infusions, Intravenous; Male; Pneumonia, Viral; Pregnancy; Retrospective Studies; Smoking

1997
Oral acyclovir prophylaxis of varicella after intimate contact.
    The Pediatric infectious disease journal, 1997, Volume: 16, Issue:12

    Whether oral acyclovir (ACV) given in late incubation can prevent clinical varicella or not.. Twenty-seven healthy infants and children susceptible to varicella received oral ACV (40 mg/kg daily in four divided doses) for 5 days, starting 9 or 11 days after exposure from the index case in the family (2 in the classroom). The clinical features were compared with 13 control children who did not receive ACV. Enzyme-linked immunoassay was used to detect varicella-zoster virus (VZV) antibody and, in follow-up immunologic studies, lymphocyte proliferative response was added. In some cases, blood culture and polymerase chain reaction with Southern hybridization were used for detection of viremia.. Among the 27 children in the treatment group, two (7.4%) developed the disease and seroconversion was observed in 17 subjects (63%). Follow-up immunologic studies in 12 of these 17 seroconverted subjects 30 months later showed persistent cellular and/or humoral immunity to VZV. Only one subject, bled 11 days after exposure, had positive VZV DNA and blood culture for VZV. On the other hand 10 of 13 (77%) control subjects developed clinical varicella.. Oral ACV administration to healthy susceptible subjects at the beginning of secondary viremia in the late incubation period (9 days after exposure) can effectively prevent or modify clinical varicella.

    Topics: Acyclovir; Administration, Oral; Antibodies, Viral; Antiviral Agents; Chickenpox; Child, Preschool; DNA, Viral; Humans; Infant

1997
Outcome of chickenpox in 66 pediatric renal transplant recipients.
    The Journal of pediatrics, 1997, Volume: 131, Issue:6

    Although chickenpox can cause severe morbidity and mortality in pediatric renal transplant recipients, published reports describing treatment of these patients are few, especially in the cyclosporine era. Sixty-nine episodes of chickenpox occurring in 66 patients were diagnosed in our transplant population between January 1984 and May 1996. Immunosuppression consisted of prednisone and azathioprine (30 cases); prednisone, azathioprine, and cyclosporine (38 cases); or prednisone alone (1 case). Azathioprine was temporarily discontinued in 66 of 68 cases. Cyclosporine was continued at the preexisting dose in 36 of 38 cases. Acyclovir was administered parenterally in 62 of 69 cases. Sixty-five of 66 patients survived. Cyclosporine use did not increase the incidence of severe disease (p > 0.1). Acute allograft rejection occurred in three patients and responded to prednisone. Chickenpox in children with renal transplants can be successfully treated with intravenous acyclovir and temporary withdrawal of azathioprine. Allograft rejection is uncommon with this approach. Patients receiving cyclosporine do not appear to experience increased morbidity or mortality with chickenpox.

    Topics: Acyclovir; Administration, Oral; Adolescent; Azathioprine; Chickenpox; Child; Cyclosporine; Drug Therapy, Combination; Graft Rejection; Humans; Immunosuppression Therapy; Incidence; Injections, Intravenous; Kidney Transplantation; Prednisone; Retrospective Studies; Survival Rate; Treatment Outcome

1997
Postexposure prophylaxis of varicella in children with leukemia by oral acyclovir.
    Pediatrics, 1996, Volume: 97, Issue:1

    Topics: Acyclovir; Administration, Oral; Antiviral Agents; Chickenpox; Female; Humans; Immunocompromised Host; Infant; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma

1996
[Visceral and neurological complications in Varicella infections of adults].
    Schweizerische medizinische Wochenschrift, 1996, Mar-16, Volume: 126, Issue:11

    Primary varicella-zoster virus (VZV) infections in adults generally follow a more severe course than in children and are more often associated with life-threatening complications. In the years 1992 to 1995 we observed 7 immunocompetent adults with a severe course of primary VZV infection. All 7 patients presented initially with a characteristic rash. In 6 patients the diagnosis of VZV was confirmed by ELISA on material taken from the lesions, and in all of them it was confirmed by serology. The following complications were observed: pneumonia (5x), elevated liver enzymes (4x), myocarditis (1x), encephalitis (1x) and myelitis (1x). Pulmonary lesions were characterized by bilateral interstitial infiltrates on chest-x-ray and required mechanical ventilation in 2 patients. The liver enzymes were only slightly elevated and clinically not significant. Myocarditis in one case was postulated in view of elevated creatine kinase levels, ECG-repolarization changes and AV-block III which required the insertion of a transitory pacemaker. Encephalitis presented as abnormal behaviour at work followed by seizures. Myelitis was suspected due to ascending sensory motor tetraparesis and confirmed by MRI. All patients were treated with high doses of parenteral acyclovir (3 x 10 mg/kg body weight i.v. per day) for 5-12 days. 6 patients recovered completely and only the patient with myelitis has residual neurological deficits 3 months after discharge. Although we cannot exclude the possibility that supportive therapy without acyclovir would have had the same outcome, we recommend high-dose parenteral acyclovir for treatment of visceral and neurological complications in primary VZV infections in adults.

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Encephalitis, Viral; Female; Herpesvirus 3, Human; Humans; Male; Middle Aged; Myelitis; Myocarditis; Pneumonia, Viral

1996
Acyclovir in chickenpox.
    Archives of disease in childhood, 1996, Volume: 74, Issue:2

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Humans; Immune Tolerance; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Infectious

1996
Prevention of varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention.
    MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 1996, Jul-12, Volume: 45, Issue:RR-11

    These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of live, attenuated varicella virus vaccine--VARIVAX--manufactured by Merck and Company, Inc. and licensed in March 1995 for use in healthy persons > or = 12 months of age. In addition to presenting information regarding vaccine, this statement updates previous recommendations concerning the use of varicella zoster immune globulin (VZIG) as prophylaxis against varicella (MMWR 1984; 33:84-90, 95-100).

    Topics: Acyclovir; Adolescent; Adult; Age Distribution; Aged; Antibodies, Viral; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Contraindications; Cost-Benefit Analysis; Cross Infection; Drug Storage; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immune Sera; Immunization, Passive; Incidence; Infant; Infant, Newborn; Middle Aged; Pregnancy; Product Surveillance, Postmarketing; Serologic Tests; Vaccination; Vaccines, Attenuated; Viral Vaccines

1996
Acute varicella hepatitis in human T-cell lymphotrophic virus types I and II infection.
    Journal of gastroenterology, 1996, Volume: 31, Issue:2

    Varicella (chicken pox) is a common viral infection in children and generally runs a benign course. However, in adults, and especially in immunocompromised subjects such as those on immunosuppressant therapy or with AIDS, varicella infection is particularly severe and is associated with the formation of hemorrhagic skin lesions and visceral involvement. These patients are at an increased risk of developing varicella hepatitis, which frequently results in fulminant hepatic failure and death. In the present report, we describe for the first time the course of disease and the histological appearance of varicella hepatitis in a patient infected with the human T cell lymphotropic viruses (HTLV) I and II; these viruses have many characteristics in common with the human immunodeficiency virus (HIV). Our patient had a relatively benign illness, suggesting that varicella infection in the presence of HTLVI and II may not run as severe a course as it does in patients with HIV infection.

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Hepatitis, Viral, Human; HTLV-I Antibodies; HTLV-I Infections; HTLV-II Antibodies; HTLV-II Infections; Humans; Liver Function Tests; Male; Middle Aged

1996
Outer retinal necrosis due to a strain of varicella-zoster virus resistant to acyclovir, ganciclovir, and sorivudine.
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1996, Volume: 22, Issue:5

    Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Arabinofuranosyluracil; Chickenpox; Drug Resistance, Microbial; Female; Ganciclovir; Herpesvirus 3, Human; Humans; Retinal Necrosis Syndrome, Acute

1996
Varicella pneumonia in a healthy adult presenting with severe respiratory failure.
    Internal medicine (Tokyo, Japan), 1996, Volume: 35, Issue:4

    We describe a case of varicella pneumonia in a 24-year-old healthy man presenting with severe respiratory failure. A chest radiograph showed diffuse, bilateral airspace consolidation; additional complications included liver dysfunction and thrombocytopenia. However, treatment with intravenous acyclovir and gamma-globulin improved his clinical symptoms and signs. A greater than four-fold change in paired titers of the varicella-zoster virus antibody was observed. Bronchoalveolar lavage performed during the recovery phase revealed increased total cell and lymphocyte counts and a decreased CD4:CD8 ratio of T lymphocytes. Transbronchial lung biopsy findings were compatible with a diagnosis of interstitial pneumonia.

    Topics: Acyclovir; Adult; Antiviral Agents; Biopsy; Chickenpox; Humans; Immunoglobulins, Intravenous; Male; Pneumonia, Viral; Respiratory Insufficiency

1996
Herpes zoster infection after bone marrow transplantation in children.
    The Journal of pediatrics, 1996, Volume: 128, Issue:3

    To determine the frequency of, risk factors for, and clinical course of herpes zoster (HZ) after bone marrow transplantation (BMT) in children.. A total of 107 children with hematologic malignancy or solid tumor who underwent allogeneic or autologous BMT were studied retrospectively.. Of the 107 patients, HZ developed in 35 (33%) after BMT; 31 (89%) of these 35 patients had localized HZ. The median onset of infection was day 96 after BMT, and 89% of cases of HZ occurred before day 365 after BMT. HZ developed in 26 (58%) of 45 patients (13/21 (62%) allogeneic and 13/24 (54%) autologous patients) with hematologic malignancy; most of these patients had undergone total body irradiation. Of 33 patients with solid tumor, HZ developed in 9 (27%). All patients with HZ were treated with acyclovir, and no patients died of complications directly resulting from HZ.. Herpes zoster occurred earlier after BMT than in adults, and it occurred frequently in children who had hematologic malignancy and/or had undergone total body irradiation. Prompt antiviral therapy reduced the mortality rate and significant morbidity associated with HZ.

    Topics: Acyclovir; Adult; Antiviral Agents; Bone Marrow Transplantation; Case-Control Studies; Chickenpox; Child; Female; Herpes Zoster; Humans; Incidence; Male; Neoplasms; Retrospective Studies; Risk Factors; Time Factors; Whole-Body Irradiation

1996
Severe varicella pneumonia in adults in Stockholm County 1980-1989.
    Scandinavian journal of infectious diseases, 1996, Volume: 28, Issue:2

    Varicella pneumonia in adults is considered to be a serious complication, with mortality rates of 9-50%, but the true incidence and clinical course is not known. We therefore studied all adult patients in Stockholm County hospitalized during the period 1980-1989 with varicella. 36/305 (12%) varicella patients admitted to hospital were diagnosed as having pneumonia, corresponding to a mean incidence of 0.32/100,000 inhabitants per year. In most patients the pneumonia had a mild to moderate clinical course and no deaths occurred (mortality rate 0%, CI95 [0, 9.7]). However, 13 patients had a severe tachypnoea (> or = 30 breaths/min) and 4 of these required intensive-care treatment. Ten patients were treated with acyclovir, in most cases combined with corticosteroids. We conclude that the incidence of severe varicella pneumonia is low in the adult population, and that the mortality rate of this complication is probably lower than previously described.

    Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Female; Hospitalization; Humans; Incidence; Male; Pneumonia, Viral; Prognosis; Retrospective Studies; Risk Factors; Survival Rate; Sweden

1996
Chronic varicella presenting as disseminated pinpoint-sized papules in a man infected with the human immunodeficiency virus.
    Dermatology (Basel, Switzerland), 1996, Volume: 192, Issue:1

    A 39-year-old HIV-infected man had manifested a typical varicella successfully treated with intravenous acyclovir. Despite oral acyclovir, he developed 10 days later a widespread eruption of pinpoint-sized erythematous papular lesions. Histologic examination and viral culture showed a persistent varicella-zoster virus (VZV) infection. Intravenous acyclovir and foscarnet were both efficient. However, each withdrawal of intravenously administered treatment resulted in a rapid relapse. Among the atypical forms of chronic varicella, this eruption appears to be unique. As in our case, chronic VZV infection appears often to be a difficult therapeutic challenge.

    Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Chickenpox; Chronic Disease; Fatal Outcome; Foscarnet; Humans; Male; Recurrence

1996
Connatal herpes zoster.
    Cutis, 1996, Volume: 58, Issue:3

    We describe a case of connatal herpes zoster present in a newborn girl whose mother had been exposed to varicella infection during the seventh month of pregnancy. A few minutes after delivery, the newborn was examined for an erythematous maculopapular rash with clear grouped vesicles involving the right L2-L4 dermatome. She was given varicella zoster immunoglobulin and oral and topical acyclovir, and all the skin lesions were completely healed eight days later. This report emphasizes one aspect of the relationship between maternal exposure to varicella zoster virus infection and the occurrence of connatal shingles, the benign course of the disease in this case, and the favorable response to acyclovir therapy in neonates.

    Topics: Acyclovir; Adult; Chickenpox; Female; Herpes Zoster; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Maternal Exposure; Pregnancy

1996
[Varicella infection at the time of cesarean section].
    Geburtshilfe und Frauenheilkunde, 1996, Volume: 56, Issue:8

    Report on a twin pregnancy terminated by Caesarean section in the 35th pregnancy week due to retardation and pathological Doppler findings in the umbilical artery and fetal aorta. At the time of Caesarean section the mother suffered from florid varicella infection. The newborns treated with varicella hyperimmunoglobulin and acyclovir developed abortive varicella exanthema without further complications.

    Topics: Acyclovir; Adult; Cesarean Section; Chickenpox; Combined Modality Therapy; Female; Fetal Growth Retardation; Humans; Immunization, Passive; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, Third; Pregnancy, Multiple; Twins

1996
[Varicella and herpes zoster. Epidemiology, physiopathology, diagnosis, development, treatment].
    La Revue du praticien, 1996, Oct-15, Volume: 46, Issue:16

    Topics: Acyclovir; Adolescent; Adult; Aged; Chickenpox; Child; Child, Preschool; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Middle Aged; Pregnancy

1996
Comparison of specific immunities to varicella-zoster virus following post-exposure prophylaxis of varicella by oral acyclovir observed in a family.
    Acta paediatrica Japonica : Overseas edition, 1996, Volume: 38, Issue:6

    An otherwise healthy 3-year-old girl developed severe varicella complicated by aseptic meningitis and received intravenous acyclovir (ACV) therapy. Her two siblings who were susceptible to varicella-zoster virus (VZV) and closely exposed to VZV in the family received oral ACV (45 or 54 mg/kg per day in four divided doses for 7 days) starting 8 days after onset of the index case for post-exposure prophylaxis of varicella. They showed only five or seven papules over the body without fever 12 days after onset of the index case, while they had one-third or half the level of antibody titer and equal sized skin reactions to VZV antigen of the index case 2.5 months later.

    Topics: Acyclovir; Administration, Oral; Antibodies, Viral; Antibody Formation; Antiviral Agents; Chickenpox; Child; Child, Preschool; Family Health; Female; Herpesvirus 3, Human; Humans; Immunity, Cellular; Male; Meningitis, Aseptic

1996
[Improvement in ichthyosis congenita after varicella infection].
    Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 1996, Volume: 47, Issue:11

    Topics: Acyclovir; Chickenpox; Child; Humans; Ichthyosis; Male; Remission, Spontaneous; Skin

1996
Varicella pneumonia in adults--clinical spectrum.
    Annals of the Academy of Medicine, Singapore, 1996, Volume: 25, Issue:6

    Varicella pneumonia is the most common complication of chickenpox and it also has the highest mortality. A retrospective study was carried out on 10 patients with varicella pneumonia over a period of one year. Seven of the 10 patients with varicella pneumonia had a history of smoking. The majority of the patients with varicella pneumonia presented with cough, dyspnoea, hypoxia and a compatible chest radiograph. All the patients with varicella pneumonia were treated with intravenous acyclovir. Four patients required mechanical ventilation. Nine out of the 10 patients were cured with only one death. It may be reasonable to select adults with varicella and who smoke, for early treatment with acyclovir.

    Topics: Acyclovir; Adult; Aged; Anti-Bacterial Agents; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Female; Humans; Incidence; Infusions, Intravenous; Male; Middle Aged; Pneumonia, Viral; Prognosis; Retrospective Studies; Risk Factors; Smoking; Survival Rate

1996
Acyclovir in chickenpox.
    Indian pediatrics, 1996, Volume: 33, Issue:12

    Topics: Acyclovir; Antiviral Agents; Chickenpox; Child; Drug Costs; Humans; Pediatrics; Practice Guidelines as Topic

1996
Verrucous herpes virus infection in human immunodeficiency virus patients.
    Archives of pathology & laboratory medicine, 1996, Volume: 120, Issue:10

    Two cases of varicella-zoster virus infection that were clinically and pathologically verrucous are reported. Although this phenomenon has previously been described in the dermatology literature, it has not, to our knowledge, been described in the pathology literature. It is important that pathologists are aware of these uncommon but histologically distinctive lesions.. The patients were seen and treated at the Departments of Dermatology of the University of Texas Health Science Center at San Antonio and Brackenridge Hospital in Austin, Tex. All information was derived from the medical records and from the attending physicians.. Verrucous lesions of herpes (varicella) zoster virus infection are rare, but they do occur in patients with the acquired immunodeficiency syndrome. Clinically, the lesions studied resembled ordinary papillomavirus-induced verrucae. Histologically, there was verrucoid epidermal hyperplasia and, unlike ordinary lesions of herpes (varicella) zoster, very little inflammation of the dermis. Diagnostic multinucleated keratinocytes with herpesvirus cytopathic changes were present within the stratum corneum.

    Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Chickenpox; Cytopathogenic Effect, Viral; Humans; Keratinocytes; Male

1996
[Post-varicella acute retinal necrosis].
    Bulletin de la Societe belge d'ophtalmologie, 1995, Volume: 255

    A man aged 43 in good health complaints of sudden blurred vision in his right eye, 12 days after a generalized chickenpox eruption. Examination shows an intraocular inflammation with retinal necrosis in temporal periphery. The serum antibodies against varicella-zoster are positive for the IgM and IgG, confirming a recent infection by varicella zoster. Bacterial serology is negative, as well as the serology for the HSV, HIV and CMV. An intraocular production of anti varicella-zoster antibodies is also found by an anterior chamber puncture (Goldmann-Witmer ratio = 1338). A general treatment by acyclovir and corticoids is started, completed by local treatment and cryocoagulation of the retinal periphery. The evolution is favorable, with recovery of the visual acuity and cicatrization of the lesions. The severity of acute retinal necrosis as a complication of a chickenpox infection usually is moderate, with a good visual prognosis as by our patient.

    Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Antibodies, Viral; Chickenpox; Cryosurgery; Drug Therapy, Combination; Humans; Male; Retinal Necrosis Syndrome, Acute; Vision Disorders

1995
Two cases of disseminated cutaneous herpes zoster in infants after intrauterine exposure to varicella-zoster virus.
    The Pediatric infectious disease journal, 1995, Volume: 14, Issue:5

    Topics: Acyclovir; Chickenpox; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Infectious Disease Transmission, Vertical; Male; Pregnancy; Pregnancy Complications, Infectious; Serologic Tests

1995
Varicella pneumonia complicating pregnancy.
    Acta obstetricia et gynecologica Scandinavica, 1995, Volume: 74, Issue:4

    Varicella pneumonia can endanger the life of pregnant women. We have a case of varicella pneumonia complicating pregnancy in the third trimester. The patient required intubation, early treatment with acyclovir (700 mg/IV every eight hours), as well as the extraction of the fetus by cesarean section before the time gestation was completed. Early treatment with acyclovir has improved hope for these patients.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Intubation; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Pregnancy Trimester, Third

1995
Acyclovir prophylaxis of varicella after household exposure.
    The Pediatric infectious disease journal, 1995, Volume: 14, Issue:2

    Topics: Acyclovir; Antibodies, Viral; Chickenpox; Child, Preschool; Family Characteristics; Female; Herpesvirus 3, Human; Humans; Infant; Male; Treatment Outcome

1995
Chickenpox during pregnancy.
    The Journal of infection, 1995, Volume: 30, Issue:1

    Topics: Acyclovir; Adult; Chickenpox; Diseases in Twins; Female; Humans; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Respiration, Artificial; Severity of Illness Index; Twins, Monozygotic

1995
Immune response to varicella-zoster virus 5 years after acyclovir therapy of childhood varicella.
    The Journal of infectious diseases, 1995, Volume: 171, Issue:5

    Topics: Acyclovir; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Herpesvirus 3, Human; Humans; Lymphocyte Activation

1995
Severe chickenpox in anabolic steroid user.
    Lancet (London, England), 1995, Jun-03, Volume: 345, Issue:8962

    Topics: Acyclovir; Adult; Anabolic Agents; Chickenpox; Critical Care; Herpesvirus 3, Human; Humans; Male; Pneumonia, Viral

1995
Acyclovir for childhood chickenpox. Has substantial potential service implications.
    BMJ (Clinical research ed.), 1995, May-13, Volume: 310, Issue:6989

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Family Practice; Humans

1995
Fatal chickenpox pneumonia in an asthmatic patient on oral steroids and methotrexate.
    Thorax, 1995, Volume: 50, Issue:4

    A 49 year old man with a long history of severe chronic asthma, treated with oral corticosteroids and weekly doses of methotrexate, contracted chickenpox from his son whose chickenpox rash had developed three weeks before presentation. Five days before admission the patient developed a vesicular skin rash which became extensive, with general malaise, bilateral pneumonia, and acute deterioration of his asthma. He died two weeks after admission despite treatment with acyclovir.

    Topics: Acyclovir; Asthma; Chickenpox; Fatal Outcome; Humans; Immunosuppression Therapy; Male; Methotrexate; Middle Aged; Pneumonia, Viral; Radiography

1995
Acyclovir for childhood chickenpox. No reason not to treat.
    BMJ (Clinical research ed.), 1995, Jan-14, Volume: 310, Issue:6972

    Topics: Acyclovir; Chickenpox; Child; Drug Costs; Humans

1995
Varicella during pregnancy. Maternal and fetal effects.
    The Western journal of medicine, 1995, Volume: 163, Issue:5

    To determine the characteristics of maternal varicella at our institution, we reviewed all cases of primary varicella in pregnancy. Using a perinatal database that summarizes all obstetric admissions, we reviewed the medical records of women with varicella infections during pregnancy. Over a 5 1/2-year period, 31 pregnancies were affected by varicella infection among 11,753 deliveries. The mean age of those patients was 19.6 years, significantly different from our overall population of 25.3 years (P < .05). The racial composition of 35% Hispanic, 35% white, and 29% African American was different from that of our general population of 55% white, 38% African American, and 6% Hispanic (P = .023). The mean gestational age of the eruption of vesicles was 25 weeks. Of the 31 women, 7 had preterm labor within a week of their varicella, 3 delivered prematurely, and 3 infants had a birth weight of less than 2,700 grams. Respiratory symptoms developed in 6 women, and pneumonia developed in 4, 2 of whom required ventilatory support, 1 for 5 days, the other for 49 days. Eight women received acyclovir during gestation, and none suffered sequelae. In all, 6 infants had lesions and anomalies noted at birth, 5 possibly associated with varicella. Varicella infection is associated with a greater-than-expected level of both maternal and fetal morbidity. The fetal disease may occur due to maternal infection at any gestation and is most likely a spectrum of complications. The maternal disease appears to be worse in the latter half of pregnancy. Programs of prevention through vaccination must account for a possibly decreased level of immunity in different populations.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Female; Gestational Age; Humans; Infant, Newborn; North Carolina; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Viral Vaccines

1995
[Varicella pneumonia in adults].
    Anales de medicina interna (Madrid, Spain : 1984), 1995, Volume: 12, Issue:12

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; HIV Seropositivity; Humans; Male; Pneumonia, Viral; Time Factors

1995
[Varicella pneumonia with multiple nodular shadows after allogeneic bone marrow transplantation in chronic myeloid leukemia].
    [Rinsho ketsueki] The Japanese journal of clinical hematology, 1995, Volume: 36, Issue:11

    A 30-year-female with chronic myelogenous leukemia received allogeneic bone marrow transplantation (BMT). On day 104, low-grade fever, cough, and general malaise developed, resulting in hospitalization 10 days later. Chest X ray revealed diffuse infitrates, suggesting cytomegalovirus interstitial pneumonia. Ganciclovir (DHPG) was given daily and all symptoms disappeared three days later. However, a very few vesicular lesions appeared on her trunk and her two children had chickenpox at that time. Chest CT was taken and disclosed diffuse nodular shadows. Clinical course and chest CT suggested varicella pneumonia. DHPG administration was stopped and acyclovir PO started to be given. She was discharged in excellent condition. In this report, we show a rare case of varicella pneumonia after allogeneic BMT and efficacy of DHPG for the treatment of varicella pneumonia.

    Topics: Acyclovir; Adult; Antiviral Agents; Bone Marrow Transplantation; Chickenpox; Female; Ganciclovir; Humans; Immunocompromised Host; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Opportunistic Infections; Pneumonia, Viral; Tomography, X-Ray Computed; Transplantation, Homologous

1995
Severity of varicella infection in Saudis with diabetes mellitus: a possible role of acyclovir in treatment.
    East African medical journal, 1995, Volume: 72, Issue:11

    Severity of varicella infection in 54 patients with diabetes mellitus seen in Arar Central Hospital, Saudi Arabia, between January 1992 and December 1994 was compared with that in 55 apparently healthy controls, seen during the same period. Persistent fever, defined as fever lasting more than five days; extensive skin eruption, defined as affecting more than 50% of the body surface; and secondary bacterial skin infection evidenced by a positive skin culture of Staphylococcus aureus or Streptococcus pyogenes occurred significantly more in diabetics than in healthy controls. The mean duration of the illness in diabetics was 16.8 +/- 3.24 days as compared to 13.6 +/- 3.32 days in healthy controls. These findings suggest that varicella runs a more aggressive course in diabetic patients compared to otherwise healthy individuals. Treatment with the anti-viral agent, acyclovir may be indicated in diabetics with varicella infection.

    Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Case-Control Studies; Chickenpox; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Male; Saudi Arabia; Severity of Illness Index; Skin Diseases, Bacterial

1995
Varicella-zoster virus infection in children with malignancy.
    Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 1994, Volume: 54, Issue:6

    Immunocompromised children are potentially threatened by infections, among which, the highly contagious chickenpox infection is the most common. In the past six months, there has been a spate of five chickenpox infections in children with malignancy, all of whom were receiving chemotherapy at that time.. The cases of 17 children with malignancies, who suffered from varicella-zoster infection during a period of chemotherapy at Taichung Veterans General Hospital were reviewed.. The diagnoses of their neoplasms were 12 acute lymphoblastic leukemia (ALL), 2 lymphoma, 3 solid tumors. The mean age was 6.8 +/- 4.0 year-old (range 3 to 15 year-old). The average duration from chickenpox skin eruption to admission was 3.3 +/- 1.8 days. Four patients suffered from abdominal pain and three of them died soon; three of them suffered from back pain and one died later. Seven of these 11 patients had impaired liver function (GOT > 45 U/L), of whom 4 died later. There were seven patients with pneumonitis, of whom five died later. Among 12 patients with ALL, 3 had absolute lymphocyte counts (ALC) < 500/mm3, but only 1 died later; 9 had ALC > 500/mm3, of whom 4 had pneumonitis, and all died later. Four patients developed disseminated intravascular coagulopathy, and three of them died later. Seven patients were prescribed acyclovir within three days after first skin eruption, none of these died. Ten patients were prescribed acyclovir three days or more after first skin eruption and five of them died later. Five patients were prescribed intravenous immunoglobulin (IVIG) within three days after first skin eruption, and none of them died; of the seven patients prescribed IVIG three days or more after first skin eruption, three died later.. Abdominal pain and disseminated intravascular coagulopathy (DIC) were signs of visceral dissemination. Severe liver function impairment, pneumonitis and DIC were the principal causes of death. Early administration of acyclovir and intravenous immunoglobulin (IVIG) can probably effectively prevent the dissemination of varicella-zoster virus (VZV). While varicella-zoster immunoglobulin (VZIG) was unavailable, IVIG was still valuable in treating VZV infection.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Female; Humans; Immunoglobulins, Intravenous; Male; Neoplasms

1994
How should one manage a child on immunosuppression who has been exposed to chickenpox and who develops chickenpox?
    Pediatric nephrology (Berlin, Germany), 1994, Volume: 8, Issue:3

    Topics: Acyclovir; Administration, Oral; Chickenpox; Child; Child, Preschool; Humans; Immunocompromised Host; Injections, Intravenous

1994
The pediatric resident susceptible to varicella: providing immunity through postexposure prophylaxis with oral acyclovir.
    The Pediatric infectious disease journal, 1994, Volume: 13, Issue:8

    Topics: Acyclovir; Administration, Oral; Antibodies, Viral; Chickenpox; Female; Humans; Infectious Disease Transmission, Patient-to-Professional; Internship and Residency; Male; Pediatrics

1994
[Acyclovir and infections caused by varicella-zoster viruses].
    La Revue du praticien, 1994, Oct-15, Volume: 44, Issue:16

    Topics: Acyclovir; Adult; Chickenpox; Child; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host

1994
[Varicella pneumonia in previously healthy adults].
    Archivos de bronconeumologia, 1994, Volume: 30, Issue:9

    Two cases of pneumonia associated with chicken pox in previously healthy patients are described. Their known risk factor was heavy smoking. Both were treated successfully with parenteral aciclovir, although one presented a restrictive spirometric pattern with lowered DLCO that became normal 3 months after discharge.

    Topics: Acyclovir; Adult; Age Factors; Chickenpox; Humans; Male; Pneumonia, Viral; Smoking; Spirometry

1994
Prophylaxis or modification of varicella by oral acyclovir after household exposure.
    Archives of disease in childhood, 1994, Volume: 70, Issue:5

    Topics: Acyclovir; Antibodies, Viral; Chickenpox; Child; Herpesvirus 3, Human; Humans

1994
Acyclovir to treat varicella.
    The Western journal of medicine, 1994, Volume: 160, Issue:4

    Topics: Acyclovir; Adolescent; Age Factors; Chickenpox; Child; Cost-Benefit Analysis; Humans

1994
[Varicella pneumonia in a healthy adult. Review of risk factors and treatment].
    Anales de medicina interna (Madrid, Spain : 1984), 1994, Volume: 11, Issue:4

    We present the case of a healthy adult patient without underlying risk factors, who developed bilateral pneumonia and respiratory failure during an outbreak in his family of infection by the Varicella-Zoster virus. IV. acyclovir treatment was begun with good clinical and radiological response and improvement in blood-oxygen levels. We review below risk factors and patients susceptible to treatment with acyclovir.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pneumonia, Viral; Risk Factors

1994
[Detection of an unusual varicella zoster virus infection in an immunosuppressed patient with polymerase chain reaction].
    Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 1994, Volume: 45, Issue:5

    We report a case of a 76-year-old patient who developed an atypical form of varicella zoster virus (VZV) reinfection. In addition to histological and serological confirmation of diagnosis, direct demonstration of VZV-DNA was possible by means of the nested polymerase chain reaction. Although VZV infection is usually diagnosed by clinical examination, the nested PCR is a sensitive and specific diagnostic procedure that can be useful especially in atypical cases.

    Topics: Acyclovir; Aged; Azathioprine; Chickenpox; Cytopathogenic Effect, Viral; Female; Herpesvirus 3, Human; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Opportunistic Infections; Pemphigus; Polymerase Chain Reaction; Prednisone

1994
Varicella in children with haematological malignancy--outcome of treatment and prevention.
    The Medical journal of Malaysia, 1994, Volume: 49, Issue:1

    Primary varicella-zoster virus infection in children with haematological malignancy is a life threatening disease. In one year, there were 10 cases of varicella and 2 cases of zoster among these children as well as 5 mothers who were accompanying their children who developed varicella in the oncology ward. Two children died of fulminating disease despite aggressive antiviral and supportive treatment. Acyclovir can be used in treatment and prophylaxis in exposed susceptible children. Varicella -zoster immune globulin is not available in this country. Vaccination with live virus has been shown to be protective in immunocompromised children and needs consideration.

    Topics: Acute Disease; Acyclovir; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Cross Infection; Disease Outbreaks; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Infection Control; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Severity of Illness Index; Survival Rate; Treatment Outcome; Vaccines, Attenuated; Viral Vaccines

1994
[Varicella pneumonia in the adult].
    Anales de medicina interna (Madrid, Spain : 1984), 1994, Volume: 11, Issue:5

    In the adult, the primary infection by the varicella-zoster virus acquires an unusual severity due to several complications, the most frequent of them being pneumonia. The authors analyze the clinical, epidemiological, serological and radiological data of the only two cases of varicellous pneumonia in the adult at a general hospital during the past 5 years. They highlight as the main characteristics: easiness of diagnosis, dissociation between clinical and radiological signs and the excellent therapeutical response to the early administration of intravenous Aciclovir. They comment as well the risk factors of this complication and the criteria for hospitalization.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Male; Pneumonia, Viral

1994
[Fatal chickenpox infection in a newborn infant].
    Nederlands tijdschrift voor geneeskunde, 1994, Aug-06, Volume: 138, Issue:32

    Topics: Acyclovir; Chickenpox; Herpesvirus 3, Human; Humans; Immunoglobulins; Infant, Newborn

1994
Relapsing chickenpox in a young man with non-Hodgkin's lymphoma.
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1994, Volume: 18, Issue:5

    Reinfection of previously "immune" patients with varicella-zoster virus can result in recurrent chickenpox. However, relapses of chickenpox are not well recognized. We describe a young man with lymphoma who rapidly developed multiple, discrete relapses of chickenpox each time therapy with acyclovir was stopped. His cutaneous infection eventually became unremitting, despite continuous treatment with acyclovir. No evidence ever suggested visceral dissemination of varicella. The patient died suddenly; the cause of death was not determined.

    Topics: Acyclovir; Adult; Antineoplastic Combined Chemotherapy Protocols; Chickenpox; Cyclophosphamide; Doxorubicin; Etoposide; Fatal Outcome; Herpesvirus 3, Human; Humans; Immunocompromised Host; Lymphoma, Non-Hodgkin; Male; Mechlorethamine; Methotrexate; Prednisone; Procarbazine; Recurrence; Vincristine; Virus Activation

1994
Acyclovir resistant varicella zoster and HIV infection.
    Archives of disease in childhood, 1994, Volume: 70, Issue:2

    A child infected with HIV who developed chronic varicella zoster virus infection resistant to acyclovir is presented. The clinical course of the infection, treatment, virological investigations, and relationship of the infection to the child's immunodeficient state are discussed.

    Topics: Acyclovir; AIDS-Related Opportunistic Infections; Chickenpox; Chronic Disease; Drug Resistance, Microbial; Fatal Outcome; Follow-Up Studies; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Male; Skin

1994
[Current developments in antiviral chemotherapy. 2: Acyclovir].
    Fortschritte der Medizin, 1994, Apr-20, Volume: 112, Issue:11

    Topics: Acyclovir; Adult; Chickenpox; Herpes Simplex; Herpes Zoster; Humans; Opportunistic Infections

1994
More on acyclovir for chickenpox.
    The New England journal of medicine, 1994, Jul-07, Volume: 331, Issue:1

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Contraindications; Female; Humans; Recurrence

1994
[What use is made of acyclovir in immunocompetent patients?].
    L'union medicale du Canada, 1994, Volume: 123, Issue:4

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Child; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Immunocompetence

1994
Cost-effectiveness of a routine varicella vaccination program for US children.
    JAMA, 1994, Feb-02, Volume: 271, Issue:5

    To evaluate the economic consequences of a routine varicella vaccination program that targets healthy children.. Decision analysis was used to compare the costs, outcomes, and cost-effectiveness of a routine vaccination program with no intervention. Clinical outcomes were based on a mathematical model of vaccine efficacy that relied on published and unpublished data and on expert opinion. Medical utilization rates and costs were collected from multiple sources, including the Kaiser Permanente Medical Care Program and the California Hospital Discharge Database.. A routine varicella vaccination program for healthy children would prevent 94% of all potential cases of chickenpox, provided the vaccination coverage rate is 97% at school entry. It would cost approximately $162 million annually if one dose of vaccine per child were recommended at a cost of $35 per dose. From the societal perspective, which includes work-loss costs as well as medical costs, the program would save more than $5 for every dollar invested in vaccination. However, from the health care payer's perspective (medical costs only), the program would cost approximately $2 per chickenpox case prevented, or $2500 per life-year saved. The medical cost of disease prevention was sensitive to the vaccination coverage rate and vaccine price but was relatively insensitive to assumptions about vaccine efficacy within plausible ranges. An additional program for catch-up vaccination of 12-year-olds would have high incremental costs if the vaccination coverage rate of children of preschool age were 97%, but would result in net savings at a coverage rate of 50%.. A routine varicella vaccination program for healthy children would result in net savings from the societal perspective, which includes work-loss costs as well as medical costs. Compared with other prevention programs, it would also be relatively cost-effective from the health care payer's perspective.

    Topics: Acyclovir; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Cost-Benefit Analysis; Decision Support Techniques; Humans; Immunization Programs; Program Evaluation; United States; Viral Vaccines

1994
Varicella in children with perinatally acquired human immunodeficiency virus infection.
    The Journal of pediatrics, 1994, Volume: 124, Issue:2

    Thirteen children with human immunodeficiency virus infection acquired perinatally and with varicella were identified. Clinical and epidemiologic information, including the use of varicella immune globulin and acyclovir, was obtained and testing for antibodies to varicella-zoster virus was done. The 13 children infected with human immunodeficiency virus had an uncomplicated clinical course, and many had a significant antibody response to varicella-zoster virus.

    Topics: Acyclovir; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Herpesvirus 3, Human; HIV Infections; Humans; Infant

1994
Synthesis and antiviral activity of novel isonucleoside analogs.
    Journal of medicinal chemistry, 1993, Apr-30, Volume: 36, Issue:9

    A series of branched-chain sugar isonucleosides was synthesized and evaluated for antiviral activity against herpesviruses. The preparation of homochiral [3S-(3 alpha, 4 beta, 5 alpha)]-2-amino-1, 9-dihydro-9-[tetrahydro-4,5-bis(hydroxymethyl)-3-furanyl]-6H-purin-6-one (7, BMS-181,164) and related compounds was stereospecifically achieved starting from 1,2-isopropylidene-D-xylofuranose (10). An efficient two-step reduction of the anomeric center of bis-acetate 18 involved formation of the chloride intermediate 19, followed by diisobutylaluminum hydride reduction. Tosylation of the resulting alcohol 20 provided the key intermediate 21, which was coupled with a variety of nucleobase anions. Several members of this new class of compounds possess activity against herpes simplex virus types 1 and 2 (HSV-1 and -2), varicella-zoster virus (VZV), and human cytomegalovirus (HCMV). Compound 7 exhibits potent and selective activity against thymidine kinase encoding herpesviruses, in particular, HSV-1 and HSV-2. Evaluation of compound 7 for inhibition of WI-38 cell growth indicated an ID50 of > 700 microM. Although the antiherpetic activity in vitro of 7 is less than that of acyclovir (1), compound 7 displays superior efficacy in mouse model infections. The (bromovinyl)uridine analog 8 (BMS-181,165) also exhibits selective activity against HSV-1 and VZV, with no cytostatic effect on WI-38 cell growth at > 800 microM. Compound 8 is active against simian varicella virus and is efficacious in the corresponding monkey model.

    Topics: Animals; Antiviral Agents; Cell Line; Chickenpox; Cytomegalovirus; Female; Guanosine; Herpes Simplex; Herpesviridae; Herpesvirus 3, Human; Mice; Molecular Structure; Simplexvirus; Structure-Activity Relationship; Thymidine Kinase; Uridine; Vaccinia virus; Viral Plaque Assay

1993
Acute retinal necrosis after chickenpox in a patient with acquired immunodeficiency syndrome.
    Archives of ophthalmology (Chicago, Ill. : 1960), 1993, Volume: 111, Issue:12

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Antibodies, Viral; CD4-CD8 Ratio; Chickenpox; Child; Female; Fundus Oculi; Herpesvirus 3, Human; Humans; Immunoglobulin G; Retinal Necrosis Syndrome, Acute; Visual Acuity

1993
Combined immunodeficiency (CID) with oligoclonal gammopathy.
    Immunodeficiency, 1993, Volume: 4, Issue:1-4

    Topics: Acyclovir; B-Lymphocytes; Chickenpox; Common Variable Immunodeficiency; Humans; Hypergammaglobulinemia; Immunoglobulin A; Immunoglobulin M; Immunoglobulins, Intravenous; Infant; Male; Paraproteins

1993
So your child has chickenpox....
    American pharmacy, 1993, Volume: NS33, Issue:9

    Topics: Acyclovir; Baths; Chickenpox; Child; Child, Preschool; Humans; Infant; Pharmacists; Time Factors

1993
Varicella-zoster virus infection in immunocompromised patients.
    Journal of medical virology, 1993, Volume: Suppl 1

    The prophylactic effect of acyclovir (ACV) on varicella-zoster virus (VZV) infection in leukaemia patients who have undergone bone marrow transplantation (BMT) was reviewed. The benefits of the use of the laminar air flow (LAF) room in the prevention of nosocomial VZV infections in the haematological ward are also discussed. Since 1986 ACV has been administered to BMT patients to prevent herpes simplex virus (HSV) infections. Of 98 patients with leukaemia who underwent BMT, 73 received ACV (200 mg five times daily) and 25 were not given ACV. In the untreated group, 9 patients (36.0%) developed VZV infection by day 67 (median) and 3 patients died due to disseminated VZV infection. In the ACV-treated group, 18 patients (24.6%) developed VZV infection by day 150 (median) and there were no deaths. From July to December 1989, nine cases of VZV infections (eight patients and one nurse) were reported in the haematological ward of the hospital. All cases originated in the conventionally ventilated areas of the ward while no VZV infections were reported in the 14 patients who occupied the LAF rooms during the same period.

    Topics: Acyclovir; Adolescent; Adult; Bone Marrow Transplantation; Chickenpox; Child; Cross Infection; Environment, Controlled; Female; Herpes Zoster; Humans; Immunocompromised Host; Leukemia; Male; Middle Aged

1993
Indications for oral acyclovir in children.
    The Pediatric infectious disease journal, 1993, Volume: 12, Issue:11

    Topics: Acyclovir; Administration, Oral; Chickenpox; Child; Humans; Stomatitis, Herpetic

1993
Acyclovir in varicella pneumonia in healthy adults.
    Respiration; international review of thoracic diseases, 1993, Volume: 60, Issue:4

    Topics: Acyclovir; Adult; Chickenpox; Humans; Lung; Male; Pneumonia, Viral; Radiography

1993
Fatal chickenpox in a patient with nephrotic syndrome.
    International journal of dermatology, 1993, Volume: 32, Issue:11

    We report our experience with two patients with adult onset of chickenpox in the setting of longstanding steroid therapy for nephrotic syndrome. Ours is a 430-bed tertiary care teaching hospital, The Wellesley Hospital, Toronto, Ontario. Both patients presented as self-referrals to the emergency department.. The clinical suspicion of chickenpox was rapidly confirmed in both cases by a Tzanck smear preparation, by viral cultures of the vesicle, serology, and skin biopsy. In both patients therapy with high dose acyclovir, 10 mg/kg q8h, intravenously, was instituted based on clinical presentation.. Delay in clinical recognition and treatment in our first case resulted in death due to multiorgan failure (MOF). Improved awareness and rapid treatment of the second patient had a favorable outcome with no sequelae.. Chickenpox is not only a childhood illness. Although rare in the adult population, it is associated even in the nonimmunocompromised host with increased morbidity and mortality. Steroid therapy predisposes to early dissemination and a potentially fatal outcome. Adults with immunosuppression should receive prompt systemic treatment with acyclovir.

    Topics: Acyclovir; Adult; Chickenpox; Fatal Outcome; Humans; Male; Multiple Organ Failure; Nephrotic Syndrome; Prednisone

1993
Effect of oral acyclovir against primary and secondary viraemia in incubation period of varicella.
    Archives of disease in childhood, 1993, Volume: 69, Issue:6

    The effect of oral acyclovir (approximately 40 mg/kg daily in four divided doses) against primary and secondary viraemia of varicella zoster virus (VZV) was examined in 27 children susceptible to VZV who were exposed to the virus in their families and their clinical features were compared with those of 19 non-treated subjects. The infection was confirmed by a fluorescent antibody to membrane antigen assay in 11 (85%) of 13 children who received acyclovir for the first seven days after exposure to VZV and in 11 (79%) of 14 who received acyclovir for the next seven days. The geometric mean antibody titre of the former group was significantly higher than that of the latter group. Varicella developed in 10 (91%) and was subclinical in one (9%) in the former group, whereas a very mild disease occurred in three (27%) and was subclinical in eight (73%) in the latter group. The severity of varicella was significantly greater in the former group than that in the latter group. On the other hand, all of the control group developed typical varicella and their clinical features were more severe than those of the acyclovir administered group. These data indicate that oral acyclovir more effectively inhibits replication of VZV in secondary viraemia than that of the primary viraemia.

    Topics: Acyclovir; Administration, Oral; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Female; Humans; Infant; Male; Time Factors; Treatment Outcome; Viremia

1993
Acyclovir.
    Indian pediatrics, 1993, Volume: 30, Issue:4

    Topics: Acyclovir; Chickenpox; Herpes Simplex; Humans

1993
Clinical manifestations of varicella-zoster virus infections in human immunodeficiency virus-infected children.
    American journal of diseases of children (1960), 1993, Volume: 147, Issue:7

    To study the clinical course of varicella-zoster infection in children infected with human immunodeficiency virus type I.. A clinical and laboratory study of human immunodeficiency virus-infected children was undertaken at Cedars-Sinai Medical Center, Los Angeles.. Twenty-seven human immunodeficiency virus-infected children aged 1 to 13 years who were treated between 1987 and 1992. Twenty-one children had acquired the infection through blood transfusion, 18 during the neonatal period and three during their early years of life. Six infants had acquired the infection perinatally.. Seventeen children have developed varicella, of whom 10 had an uncomplicated course and seven suffered from chronic, recurrent, or persistent varicella. Uncomplicated or recurrent varicella was a relatively benign illness that did not require antiviral therapy except in one child. In contrast, patients with persistent varicella required antiviral therapy as they were sicker and had a prolonged course. One had pneumonia, and another patient developed hyperkeratotic lesions that were refractory to therapy. They had lower CD4 counts (P < .01) and had a more advanced stage of the human immunodeficiency virus disease than the other children. Three patients who were receiving regular intravenous immunoglobulin developed their initial attack of varicella despite the presence of the varicella-zoster antibody. Four patients, three of whom had uncomplicated varicella, developed zoster involving one or two dermatomes. One patient developed zoster while receiving acyclovir therapy.. Children infected with human immunodeficiency virus type 1 may suffer unusual manifestations of varicella-zoster infection. The incidence of zoster in these children is higher than in the general population and is close to that in patients with leukemia. The effectiveness of antiviral therapy in these patients was difficult to evaluate.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; HIV Infections; HIV-1; Humans; Infant; Recurrence

1993
Acyclovir for varicella in immunocompetent patients.
    The Clinical investigator, 1993, Volume: 71, Issue:6

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Child; Humans; Immunocompromised Host; Prospective Studies; Randomized Controlled Trials as Topic; Retrospective Studies

1993
Chickenpox in pregnancy. Acyclovir for uncomplicated chickenpox?
    BMJ (Clinical research ed.), 1993, May-29, Volume: 306, Issue:6890

    Topics: Acyclovir; Chickenpox; Female; Humans; Pregnancy; Pregnancy Complications, Infectious

1993
What's new in chickenpox (varicella-zoster) infection?
    The Western journal of medicine, 1993, Volume: 158, Issue:2

    Topics: Acyclovir; Adolescent; Adult; Antibodies, Viral; Chickenpox; Child; Herpesvirus 3, Human; Humans; Latex Fixation Tests; Viral Vaccines

1993
American Academy of Pediatrics Committee on Infectious Diseases: The use of oral acyclovir in otherwise healthy children with varicella.
    Pediatrics, 1993, Volume: 91, Issue:3

    Oral acyclovir therapy initiated within 24 hours of illness for otherwise healthy children with varicella typically will result in a 1-day reduction of fever and approximately a 15% to 30% reduction in the severity of cutaneous and systemic signs and symptoms. Therapy has not been shown to reduce the rate of acute complications, pruritus, spread of infection,or duration of absence from school. Its long-term effect on the rate of occurrence of zoster is unknown. To date, no significant adverse effects of oral acyclovir therapy in otherwise healthy children have been demonstrated. In adults, delay of therapy beyond the first 24 hours of illness results in loss of therapeutic effect. The cost-benefit ratio of therapy is currently unknown, and its determination is extremely complex.. 1. Oral acyclovir therapy is not recommended routinely for the treatment of uncomplicated varicella in otherwise healthy children. This recommendation is based on the marginal therapeutic effect, the cost of the drug, feasibility of drug delivery in the first 24 hours of illness. Such a decision should be based on an informed discussion among the physician, parent, and patient. 2. For certain groups at increased risk of severe varicella or its complications, oral acyclovir therapy for varicella, if it can be initiated within the first 24 hours after the onset of rash, should be considered. These groups include the following: a. Otherwise healthy, nonpregnant individuals 13 years of age or older. b. Children older than 12 months with a chronic cutaneous or pulmonary disorder and those receiving long-term salicylate therapy, although in the latter instance a reduced risk for Reye syndrome has not been shown to result from oral acyclovir therapy nor from milder illness with varicella.(ABSTRACT TRUNCATED AT 250 WORDS)

    Topics: Acyclovir; Administration, Oral; Adolescent; Chickenpox; Child; Child, Preschool; Herpesvirus 3, Human; Humans

1993
Postexposure prophylaxis of varicella in family contact by oral acyclovir.
    Pediatrics, 1993, Volume: 92, Issue:2

    To determine whether varicella can be prevented by administration of oral acyclovir (ACV) during the incubation period of the disease.. ACV (40 or 80 mg/kg daily in four divided doses) was given orally to 25 exposed infants and children for 7 days, starting 7 to 9 days after exposure from the index case in their families. Their clinical features were compared with those of 25 age-matched control subjects who had been exposed in their families but did not receive ACV. A fluorescent antibody to membrane antigen assay was used for determination of the antibody to varicella-zoster virus, and a nested polymerase chain reaction method was used for detection of viremia.. Among the 25 who received ACV, 4 (16%) developed the disease and 1 (4%) had a fever. On the other hand, all of 25 control subjects developed the disease and 17 (68%) had a fever. The incidence of fever and the severity of skin rashes were significantly lower (P < .01) in the subjects who received oral ACV than in the control group. Seroconversion was observed in 84% of subjects who received ACV. In some cases, varicella-zoster virus DNA was detected by polymerase chain reaction amplification in peripheral blood mononuclear cells from blood drawn approximately 14 days after exposure.. Varicella can be prevented or modified by administration of oral ACV late in the incubation period.

    Topics: Acyclovir; Administration, Oral; Antibodies, Viral; Chickenpox; Child; Child, Preschool; Family; Female; Herpesvirus 3, Human; Humans; Infant; Male

1993
Severe chickenpox after intranasal use of corticosteroids.
    The Journal of pediatrics, 1993, Volume: 123, Issue:4

    Two children were hospitalized for severe chickenpox after intranasal use of corticosteroids for chronic sinusitis. One had unusually extensive cutaneous disease with delayed progression of lesions, dehydration, and prolonged fever; the other had hemorrhagic cutaneous lesions, hepatitis, and pneumonitis. Both were treated with intravenous acyclovir infusion and recovered. Systemic or local immunosuppression after intranasal corticosteroid administration may have predisposed the children to severe varicella infection.

    Topics: Acyclovir; Administration, Intranasal; Adolescent; Beclomethasone; Chickenpox; Child; Female; Humans; Immune Tolerance; Immunocompromised Host; Male; Sinusitis

1993
Risks of chickenpox in asthmatic children receiving inhalation steroids and therapeutic recommendations.
    The Pediatric infectious disease journal, 1993, Volume: 12, Issue:2

    Topics: Acyclovir; Administration, Inhalation; Adrenal Cortex Hormones; Asthma; Causality; Chickenpox; Child; Child, Preschool; Humans; Immunoglobulins, Intravenous; Risk Factors

1993
Use of acyclovir in varicella.
    Pediatric emergency care, 1993, Volume: 9, Issue:1

    Topics: Acyclovir; Adult; Asthma; Chickenpox; Child; Female; Humans; Male; Steroids

1993
Acyclovir should not be used routinely for chickenpox, says pediatrics academy.
    Clinical pharmacy, 1993, Volume: 12, Issue:3

    Topics: Acyclovir; Adolescent; Chickenpox; Humans; Infant

1993
Chickenpox during pregnancy.
    BMJ (Clinical research ed.), 1993, Apr-24, Volume: 306, Issue:6885

    Topics: Acyclovir; Adult; Chickenpox; Congenital Abnormalities; Female; Fetal Diseases; Humans; Immunoglobulins, Intravenous; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious

1993
Does acyclovir worsen late varicella?
    Annals of internal medicine, 1993, Mar-01, Volume: 118, Issue:5

    Topics: Acyclovir; Chickenpox; Humans; Time Factors

1993
Managing childhood chickenpox: cost implications.
    PharmacoEconomics, 1993, Volume: 3, Issue:2

    Topics: Acyclovir; Chickenpox; Child; Cost of Illness; Humans; Treatment Outcome

1993
Chickenpox in adult renal allograft recipients.
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 1992, Volume: 7, Issue:3

    Topics: Acyclovir; Adult; Chickenpox; Humans; Kidney Transplantation; Male; Transplantation, Homologous

1992
Varicella in pediatric renal transplant recipients.
    Pediatrics, 1992, Volume: 90, Issue:2 Pt 1

    As of November 1991, 8 of 83 children who had received renal transplants at Massachusetts General Hospital since January 1979 required admission for primary varicella. All 8 had cutaneous manifestations of disease, and 4 had evidence of visceral disease. Three of these 8 children received varicella zoster immune globulin (VZIG) after exposure to varicella; in the remaining children, exposure was not revealed until symptoms were present. All 8 children were treated with high-dose intravenous acyclovir. Two children died of complications of varicella infection, including 1 child who received VZIG on the day of exposure to varicella. Neither VZIG prophylaxis nor treatment with intravenous acyclovir offers complete protection against severe varicella infection to immunosuppressed children who have received organ transplants. A high priority should be given to the evaluation of alternative treatments, such as vaccination to the varicella virus, which could be administered to susceptible transplant candidates, preferably prior to transplantation.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Female; Herpesvirus 3, Human; Humans; Immune Sera; Immunization, Passive; Kidney Transplantation; Male

1992
Acyclovir in chickenpox.
    The New England journal of medicine, 1992, Apr-30, Volume: 326, Issue:18

    Topics: Acyclovir; Chickenpox; Child; Humans

1992
Controversy about chickenpox.
    Lancet (London, England), 1992, Sep-12, Volume: 340, Issue:8820

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Humans; Vaccines, Attenuated

1992
Varicella and acyclovir.
    Lancet (London, England), 1992, Dec-05, Volume: 340, Issue:8832

    Topics: Acyclovir; Chickenpox; Humans; Immunocompetence

1992
Rational use of acyclovir in the treatment of mucocutaneous herpes simplex virus and varicella zoster virus infections.
    Seminars in dermatology, 1992, Volume: 11, Issue:3

    The herpes family of viruses establishes latent infection in neurons and produces a spectrum of acute and recurrent clinical disease. Therapies to terminate the neurolatency or to enhance host responses are not yet available. Current therapy consists of antiviral drugs, which interfere with viral replication, can favorably alter the signs and symptoms of symptomatic disease, and act as prophylaxis against recurrent disease. Because the severity of acute and recurrent herpes group infection varies greatly between individuals, proper selection of patients to be treated with antiviral therapy is important. In general in immunocompetent patients, antiviral therapy has the greatest potential benefit for patients early in the course of primary or initial disease, or for patients with frequent and/or severe recurrent disease. Patients late in acute disease or with infrequent and/or mild recurrent disease are very unlikely to benefit from antiviral therapy. With immunocompromised patients, antiviral therapy is of the greatest potential value. By careful selection of patients, the clinician can maximize the benefits of antiviral therapy for patients with cutaneous herpes group viral infections.

    Topics: Acyclovir; Chickenpox; Herpes Genitalis; Herpes Labialis; Herpes Simplex; Herpes Zoster; Humans; Recurrence

1992
[Treatment of varicella with acyclovir in children with normal immune defense?].
    Nederlands tijdschrift voor geneeskunde, 1992, Oct-17, Volume: 136, Issue:42

    Topics: Acyclovir; Adolescent; Age Factors; Chickenpox; Child; Child, Preschool; Humans; Immunologic Deficiency Syndromes

1992
Safe use of acyclovir (Zovirax) in renal transplant patients on cyclosporine A therapy: case reports.
    Transplantation proceedings, 1992, Volume: 24, Issue:5

    Topics: Acyclovir; Adult; Chickenpox; Child; Creatinine; Cyclosporine; Drug Interactions; Herpes Zoster; Humans; Kidney Transplantation; Urea

1992
Risk of acyclovir therapy in pregnant adolescent.
    The Journal of pediatrics, 1992, Volume: 121, Issue:5 Pt 1

    Topics: Acyclovir; Adolescent; Chickenpox; Female; Humans; Pregnancy; Pregnancy Tests

1992
[Prevention of chickenpox with acyclovir].
    Anales espanoles de pediatria, 1992, Volume: 37, Issue:5

    Topics: Acyclovir; Apgar Score; Chickenpox; Female; Gestational Age; Humans; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Infectious

1992
Acute retinal necrosis after chickenpox in a healthy adult.
    Annals of ophthalmology, 1992, Volume: 24, Issue:9

    A healthy man had acute retinal necrosis (ARN) two weeks after diffuse varicella eruption. Treatment with acyclovir and corticosteroids was associated with a favorable clinical outcome. To our knowledge, there are no reported occurrences of permanent visual loss or retinal detachment in healthy patients with postvaricella ARN.

    Topics: Acyclovir; Adult; Chickenpox; Cyclopentolate; Follow-Up Studies; Fundus Oculi; Humans; Male; Prednisolone; Retinal Necrosis Syndrome, Acute; Treatment Outcome; Visual Acuity

1992
[Fatal varicella pneumonia unresponsive to acyclovir therapy in a child with a malignancy].
    Mikrobiyoloji bulteni, 1992, Volume: 26, Issue:3

    Acyclovir has become the drug of choice for prevention of visceral dissemination of Varicella-zoster virus infections in immunocompromised individuals. This article describes a 6-year-old girl taking cytotoxic therapy and radiotherapy for treatment of Hodgkin lymphoma who developed cutaneous varicella infection. Despite the early administration of acyclovir a fatal varicella pneumonia occurred and she died on the 4th day of hospitalization. Since the resistance is inducible, the increase of unresponsiveness to acyclovir in immunocompromised hosts with varicella infection is a potential risk that can cause to increase in fatalities in these patients.

    Topics: Acyclovir; Chickenpox; Child; Female; Hodgkin Disease; Humans; Immunocompromised Host; Pneumonia; Radiography; Risk Factors; Treatment Outcome

1992
Unusual onset of severe varicella in adult immunocompromised patients.
    Annals of hematology, 1992, Volume: 64, Issue:3

    Abdominal and back pain has until now been reported as a first sign of severe varicella in immunocompromised children only. We report two adult leukemia patients in whom these symptoms preceded visceral dissemination of varicella infection. Recognizing that this syndrome may occur in adult patients is of clinical importance, since it allows early diagnosis and treatment of the infection.

    Topics: Abdominal Pain; Acyclovir; Adult; Back Pain; Chickenpox; Humans; Immunocompromised Host; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma

1992
Oral acyclovir treatment of chickenpox in normal adolescents.
    The Journal of pediatrics, 1992, Volume: 120, Issue:4 Pt 1

    Topics: Acyclovir; Adolescent; Chickenpox; Cicatrix; Humans; Superinfection

1992
Acyclovir therapy in neonates.
    The Journal of pediatrics, 1992, Volume: 120, Issue:4 Pt 1

    Topics: Acyclovir; Chickenpox; Drug Administration Schedule; Humans; Infant, Newborn

1992
Treatment of varicella with low doses of acyclovir for two days.
    The Journal of pediatrics, 1992, Volume: 120, Issue:4 Pt 1

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Drug Administration Schedule; Humans

1992
Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): response to acyclovir.
    Journal of the Royal Society of Medicine, 1992, Volume: 85, Issue:3

    Topics: Acyclovir; Chickenpox; Female; Growth; Histiocytosis, Sinus; Humans; Infant

1992
Acyclovir in chickenpox.
    The New England journal of medicine, 1992, Apr-30, Volume: 326, Issue:18

    Topics: Acyclovir; Chickenpox; Humans; Nonprescription Drugs

1992
Acyclovir in chickenpox.
    The New England journal of medicine, 1992, Apr-30, Volume: 326, Issue:18

    Topics: Acyclovir; Chickenpox; Child; Drug Resistance, Microbial; Humans

1992
Use of acyclovir in the treatment of chickenpox.
    Pediatrics, 1992, Volume: 89, Issue:4 Pt 1

    Topics: Acyclovir; Chickenpox; Child; Drug Evaluation; Humans

1992
Acyclovir approved for childhood chickenpox.
    The Nurse practitioner, 1992, Volume: 17, Issue:5

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Clinical Trials as Topic; Humans; United States; United States Food and Drug Administration

1992
[Facial paralysis and chicken-pox].
    Revue neurologique, 1992, Volume: 148, Issue:1

    Ten days after chicken-pox, a 24-year old man presented with a right facial palsy without meningitis. Albumino-cytologic dissociation in CSF--not observed in two other published cases--suggests an immune-mediated process. The patient was treated by prednisone and aciclovir. The upper facial muscles remained paretic 2 months after onset.

    Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Chickenpox; Facial Paralysis; Humans; Male

1992
[Prevention against chickenpox in children is unnecessary!].
    Lakartidningen, 1992, Jun-03, Volume: 89, Issue:23

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Humans; Infant; Sweden; United States; United States Food and Drug Administration

1992
Chickenpox-associated acute retinal necrosis syndrome.
    Ophthalmology, 1991, Volume: 98, Issue:11

    Acute retinal necrosis (ARN) syndrome usually occurs as the result of secondary reactivation of latent, previously acquired, varicella-zoster or herpes simplex virus. The authors report four patients who developed a mild form of ARN within 1 month (5 to 28 days) after the onset of chickenpox. In contrast to typical cases of ARN, these cases were less severe, with retinitis limited to two quadrants or less (three patients), no retinal detachment (four patients), minimal vitreitis (four patients), and no loss of visual acuity (four patients). Thus, ARN may occur during the course of primary varicella-zoster infection.

    Topics: Acyclovir; Adult; Antibodies, Viral; Chickenpox; Child; Female; Fundus Oculi; Herpesvirus 3, Human; Humans; Male; Prednisone; Retinal Necrosis Syndrome, Acute; Visual Acuity

1991
Oral acyclovir for chickenpox.
    Cutis, 1991, Volume: 48, Issue:5

    Topics: Acyclovir; Chickenpox; Child; Humans

1991
Varicella pneumonia as the presenting manifestation of immunodeficiency.
    Clinical pediatrics, 1991, Volume: 30, Issue:9

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Dysgammaglobulinemia; Female; Humans; IgG Deficiency; Immunoglobulin M; Immunoglobulins, Intravenous; Infusions, Intravenous; Lymphocyte Subsets; Male; Oxygen Inhalation Therapy; Pneumonia, Viral

1991
Oral acyclovir for chickenpox.
    Cutis, 1991, Volume: 48, Issue:1

    We report on our experience with acyclovir (Zovirax) capsules for the symptomatic treatment of chickenpox in two children and an adult.

    Topics: Acyclovir; Administration, Oral; Capsules; Chickenpox; Child; Family Health; Female; Humans; Middle Aged

1991
Parenteral and oral acyclovir for management of varicella pneumonia in pregnancy: a case report with review of literature.
    The West Virginia medical journal, 1991, Volume: 87, Issue:5

    Varicella pneumonia is a relatively rare disease in the reproductive-aged woman, but has a reported 41 percent maternal mortality rate in pregnancy. Seventeen cases managed with intraveneous acyclovir are reviewed. We report successful management with the unpublished addition of oral acyclovir to complete antiviral therapy on an outpatient basis.

    Topics: Acyclovir; Administration, Oral; Chickenpox; Female; Humans; Infant, Newborn; Injections, Intravenous; Male; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious

1991
Varicella-zoster infection in adults with cystic fibrosis: role of acyclovir.
    Scandinavian journal of infectious diseases, 1991, Volume: 23, Issue:3

    Of 159 adult patients with cystic fibrosis, 5 were documented to have varicella-zoster infection that resulted in an infective pulmonary exacerbation that required intravenous acyclovir and additional antibiotic treatment. Stable serial pulmonary function values were observed over a 1-year period in 4 patients and no complications resulted from treatment. Early treatment with acyclovir in combination with appropriate antibiotics may prevent pulmonary deterioration in adult patients with cystic fibrosis who develop varicella-zoster infection.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Cystic Fibrosis; Female; Herpes Zoster; Humans; Male; Pseudomonas Infections; Respiratory Function Tests; Respiratory Tract Infections

1991
Use of acyclovir for varicella.
    The Journal of pediatrics, 1991, Volume: 118, Issue:1

    Topics: Acyclovir; Chickenpox; Child; Humans; Parents

1991
Successful acyclovir therapy of severe varicella hepatitis in an adult renal transplant recipient.
    The American journal of medicine, 1991, Volume: 90, Issue:3

    Topics: Acyclovir; Chickenpox; Hepatitis, Viral, Human; Herpes Zoster; Humans; Kidney Transplantation

1991
Preventing recurrent varicella and herpes zoster with oral acyclovir in HIV-seropositive patients.
    Clinical pharmacy, 1991, Volume: 10, Issue:4

    Topics: Acyclovir; Administration, Oral; Adult; Chickenpox; Herpes Zoster; HIV Seropositivity; Humans; Male; Recurrence

1991
[Acyclovir and specific anti-varicella-herpes zoster immunoglobulins in the treatment of varicella-zoster virus infection in 113 adults].
    Pathologie-biologie, 1990, Volume: 38, Issue:5 ( Pt 2)

    From January 1978 to December 1988, 54 males and 59 females were treated for varicella, zoster and disseminated zoster by varicella-zoster immunoglobulin (group I) or acyclovir (group II). 67 patients had immune deficiency disease. Treatment was successful for 92/100 patients in group I and for 100/100 patients in group II. Thrombophlebitis and renal failure were observed in group II and regressed when acyclovir was stopped. Varicella-zoster immunoglobulin and acyclovir are two effective therapeutics in the treatment of varicella and zoster in adults including immunocompromised patients. The use of acyclovir could not reduce the duration of hospitalization.

    Topics: Acyclovir; Adult; Chickenpox; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immune Tolerance; Immunization, Passive; Immunoglobulins; Male

1990
Treatment of adult chickenpox with oral acyclovir.
    Archives of internal medicine, 1990, Volume: 150, Issue:10

    Thirty-one late adolescents and adults with varicella were studied. Patients identified within 72 hours of varicella exanthem were offered open treatment with acyclovir (4 g/d), and those patients identified after 72 hours of exanthem were followed up but not treated. Twenty-two patients were treated with acyclovir. Nine patients were not treated. No severe complications occurred in any of the 31 patients. Minor complications, including prolonged fever, localized secondary infections, persistent cough, and prolonged fatigue were more frequent in the untreated group. If the acyclovir therapy was begun within the first 24 hours of varicella exanthem, then the rash and clinical illness were dramatically lessened. Treatment with oral acyclovir should be considered for varicella in adults who are identified within the first 24 hours of exanthem.

    Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Chickenpox; Female; Follow-Up Studies; Humans; Male; Multivariate Analysis; Time Factors

1990
Management of varicella pneumonia complicating pregnancy.
    American journal of perinatology, 1990, Volume: 7, Issue:4

    We report five cases of varicella pneumonia during pregnancy. Prompt diagnosis along with aggressive management, including antiviral chemotherapy and ventilatory support, may improve maternal and neonatal outcome.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pneumonia; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Respiration, Artificial; Vidarabine

1990
Chickenpox chorioretinitis.
    The British journal of ophthalmology, 1990, Volume: 74, Issue:11

    Chickenpox infection in an adult was complicated by peripheral chorioretinitis and treated with oral acyclovir. Similarities of this case to the recently proposed mild type of acute retinal necrosis syndrome are discussed.

    Topics: Acyclovir; Administration, Oral; Adult; Chickenpox; Chorioretinitis; Female; Humans

1990
Early relapses of varicella-zoster virus infection in immunocompromised children treated with acyclovir.
    Acta paediatrica Hungarica, 1990, Volume: 30, Issue:2

    Authors observed one or more early VZV relapses in 8 out of 98 Acyclovir treated immunocompromised children with varicella. None of the 8 children developed VZV antibodies by the end of the 5-day ACV treatment. All VZV relapses were successfully treated with ACV or Vidarabine, but were stopped only after the appearance of VZV antibodies in the patients' sera. The possible role of ACV treatment in pathogenesis of early VZV relapses could be excluded by comparing the VZV antibody production of patients treated with ACV from the first day of varicella on with the antibody response of those, who received ACV as late as on the 5th day of varicella. By prolonging the ACV treatment till the appearance of VZV antibodies, early relapses could be avoided.

    Topics: Acyclovir; Adolescent; Antibody Formation; Chickenpox; Child; Child, Preschool; Herpes Zoster; Humans; Immune Tolerance; Infant; Recurrence; Time Factors

1990
Acyclovir-resistant varicella zoster virus infection after chronic oral acyclovir therapy in patients with the acquired immunodeficiency syndrome (AIDS).
    Annals of internal medicine, 1990, Feb-01, Volume: 112, Issue:3

    Four patients with human immunodeficiency virus (HIV) infection who received chronic oral acyclovir therapy for suppression of recurrent varicella zoster or herpes simplex virus infection developed persistent disseminated hyperkeratotic papules that failed to heal with intravenous or high-dose oral acyclovir therapy. Varicella zoster virus, resistant to acyclovir in vitro, was isolated from skin lesions of all four patients. Three patients were adults in whom the acquired immunodeficiency syndrome (AIDS) had been diagnosed 12 to 20 months before isolation of acyclovir-resistant varicella zoster virus. The fourth patient was a perinatally HIV-infected child who developed primary varicella infection at age 7 years when profoundly immunosuppressed (absolute CD4+ lymphocyte count less than 50 cells/microL). Mean antiviral susceptibilities (ED50 values) of the four clinical isolates compared with the ED50 values of the reference strain Oka were 85 compared with 3.3 mumol/L for acyclovir, 1.4 compared with 0.8 mumol/L for vidarabine, and 123 compared with 117 mumol/L for foscarnet. When assayed by [125I]-dC plaque autoradiography, 90% to 100% of the viral isolate populations had altered or no measurable thymidine kinase function. Acyclovir-resistant varicella zoster virus infection may complicate long-term oral acyclovir administration in patients with AIDS and may be associated with the appearance of atypical hyperkeratotic papules.

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Chickenpox; Child; Drug Resistance, Microbial; Herpes Zoster; Humans; Keratosis; Male; Recurrence; Skin Diseases, Infectious

1990
Chickenpox: where do we stand with treatment?
    The Journal of pediatrics, 1990, Volume: 116, Issue:4

    Topics: Acyclovir; Chickenpox; Child; Humans

1990
[Prophylaxis in severe congenital neonatal varicella. Apropos of two cases].
    Anales espanoles de pediatria, 1989, Volume: 31, Issue:6

    We present two cases of neonatal varicella in newborn twins, who had serious complications in spite of being given human anti-chickenpox immuneglobulin (zoster immuneglobulin ZIG) prophylaxis. We comment on current criteria of the prophylaxis in newborns with risk of severe neonatal varicella.

    Topics: Acyclovir; Chickenpox; Diseases in Twins; Female; gamma-Globulins; Humans; Immunization, Passive; Infant, Newborn; Male

1989
Comparison of acyclovir and vidarabine in immunocompromised children with varicella-zoster virus infection.
    Acta paediatrica Japonica : Overseas edition, 1989, Volume: 31, Issue:6

    Intravenous acyclovir and vidarabine were compared in the treatment of varicella-zoster virus (VZV) infection in 25 immunocompromised children--13 with acute lymphocytic leukemia, three with other types of cancer, two with immunodeficiency and in seven undergoing prednisolone treatment. Thirteen had varicella and 12 had herpes zoster. Acyclovir was given intravenously to five patients with varicella and to four with herpes zoster at a dose of 5-10 mg/kg every eight hours. Vidarabine was given intravenously to eight patients with varicella and to eight with herpes zoster at a dose of 10 mg/kg/day. In varicella, vidarabine significantly shortened the time from the start of treatment to cessation of new lesion formation compared with acyclovir. However, there was no significant difference in time to complete crusting between the two treatments. In herpes zoster, acyclovir significantly shortened the time from the onset of the skin lesions to complete crusting. A slight raise of GOT in two cases was reported. While acyclovir and vidarabine were equally effective for VZV infection, in herpes zoster acyclovir was more effective.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Drug Administration Schedule; Female; Herpes Zoster; Humans; Male; Opportunistic Infections; Vidarabine

1989
Varicella in pediatric orthotopic liver transplant recipients.
    Pediatrics, 1989, Volume: 83, Issue:2

    From May 1981 to May 1984, 90 pediatric patients underwent liver transplantation and 65 patients survived as of May 1986. Two of the nonsurvivors died with complications related to clinical varicella. Of these 67 patients (65 survivors and two nonsurvivors who died of varicella-related causes), 51 patients were determined to be varicella susceptible. Clinical disease developed in no patients with serologic evidence or clinical history of varicella prior to transplantation. Eighteen susceptible patients were exposed and received zoster immune globulin and varicella did not develop. Clinical disease developed in eight patients despite zoster immune globulin, although one patient received it 96 hours after exposure. Six patients received no zoster immune globulin and clinical varicella developed. In all, varicella developed in 14 patients. Thirteen were admitted to the hospital and treated with intravenous acyclovir. Of those treated, two died of causes related to complications of varicella. The remaining patients treated with acyclovir had mild disease. The one patient not treated with acyclovir also had mild disease. We conclude that patients contracting varicella after liver transplantation while receiving maintenance immunosuppressive agents should be treated with intravenous acyclovir. Generally, when treated with acyclovir while receiving maintenance immunosuppressive drugs, these patients have mild clinical disease. Patients recently treated with high-dose prednisone and cyclosporine may have severe clinical disease resulting in death.

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Cyclosporins; Female; Herpesvirus 3, Human; Humans; Immunization, Passive; Liver Transplantation; Male; Postoperative Complications; Prednisone

1989
[Neonatal varicella: indications for the use of varicella-zoster specific immunoglobulin].
    Anales espanoles de pediatria, 1989, Volume: 31, Issue:3

    Case reports from January-1986 through December-1988 of neonates born to women who develop varicella and neonates with household postnatal exposure are presented. Mother developed varicella in three cases (15 days before delivery, at delivery, 10 days after delivery), the last case was infected by direct exposure from his brothers. Only neonates with household contacts developed varicella. In every case varicella-zoster immunoglobulin a doses of 0.2 mg/kg/day from the three days was administered. Adding aciclovir intravenous a daily doses of 15 mg/kg/8h for seven days in neonates who developed varicella. Are propose considered a high risk group the neonates with postnatal exposure.

    Topics: Acyclovir; Chickenpox; Female; Fetal Diseases; Humans; Immune Sera; Immunization, Passive; Infant, Newborn; Male; Pregnancy; Risk Factors

1989
[Severe varicella pneumopathy in health adults. Apropos of a case].
    Revue de pneumologie clinique, 1989, Volume: 45, Issue:6

    The authors report a new case of respiratory distress syndrome which occurred as complication of varicella in an otherwise healthy adult patient. The case is well documented by images and immunological studies which are discussed in the light of recently published data.

    Topics: Acyclovir; Adult; Chickenpox; Humans; Lung Diseases; Male; Tomography, X-Ray Computed

1989
[Clinical signs and symptoms, and chemotherapy of varicella zoster virus infection].
    Nihon rinsho. Japanese journal of clinical medicine, 1989, Volume: 47, Issue:2

    Topics: Acyclovir; Chickenpox; Diagnosis, Differential; Humans; Prognosis; Vidarabine

1989
Varicella pneumonia in the adult.
    New Jersey medicine : the journal of the Medical Society of New Jersey, 1989, Volume: 86, Issue:6

    Chickenpox pneumonia can occur in as many as half of the varicella-zoster infections in adults. Although it usually exhibits a benign course, this complication can cause considerable morbidity and mortality in predisposed groups, including pregnant women and immunosuppressed patients. In these patients, the use of antiviral drugs, most notably acyclovir, has been shown to lessen the morbidity of varicella-zoster infections. Early diagnosis of lung involvement from the chest x-ray or arterial blood gas measurements, even in the absence of symptoms, is essential for optimum efficacy of drug therapy. The use of acyclovir in normal hosts continues to be debated, especially for prophylaxis, because of its potential for nephrotoxicity. Judicious use of acyclovir will reduce the overall mortality from this potentially fatal complication of varicella zoster virus infection.

    Topics: Acyclovir; Adult; Chickenpox; Humans; Male; Pneumonia, Viral; Pulmonary Diffusing Capacity

1989
Varicella-zoster virus infections in children infected with human immunodeficiency virus.
    The Pediatric infectious disease journal, 1989, Volume: 8, Issue:9

    Primary varicella-zoster (VZ) infection in eight children with perinatally acquired human immunodeficiency virus infection tended to be severe, prolonged, complicated by bacterial infections and in one case fatal. Depletion of CD4-lymphocytes was associated with chronic and recurrent VZ infection. In some patients convalescent VZ antibody titers were low and did not correlate with recurrence of VZ lesions. Administration of acyclovir appeared to be beneficial in suppressing VZ in human immunodeficiency virus-infected children with primary or recurrent VZ infection.

    Topics: Acyclovir; Bacterial Infections; Chickenpox; Child; Child, Preschool; Female; Hepatitis, Viral, Human; HIV Infections; Humans; Infant; Male; Pneumonia, Viral; Recurrence

1989
[Severe pulmonary varicella in 7 non-immunodepressed adults].
    Revue des maladies respiratoires, 1988, Volume: 5, Issue:1

    We report seven cases of seven pulmonary varicella occurring in seven adults without any previous history of known immunological deficit. In all the cases the vesicular eruption was diffuse, occurring after contact with a child presenting with benign varicella. The respiratory signs appeared five to seven days after the cutaneous signs. On admission there was significant hypoxaemia (PaO2 = 35 to 47 mmHg on air), requiring positive pressure expiration (10 to 18 cmH2O) on mechanical ventilation (4 times) or spontaneous ventilation (3 times). The pulmonary radiographs showed diffuse nodular interstitial shadowing. Treatment consisted of Acyclovir (10 mg/kg/8 h). Five patients were cured without any sequellae five to six days after ventilation. One patient died (3 months pregnant), 1 patient presented with a superinfection with staphylococcus aureus. The occurrence of respiratory signs in an adult presenting with varicella requires hospitalisation for treatment with Acyclovir and also the prevention of superinfections.

    Topics: Acyclovir; Adult; Chickenpox; Female; Herpesvirus 3, Human; Humans; Hypoxia; Male; Pneumonia, Pneumococcal

1988
Varicella infection with profound neutropenia, multisystem involvement and no sequelae.
    The Pediatric infectious disease journal, 1988, Volume: 7, Issue:6

    Topics: Acyclovir; Agranulocytosis; Antibodies, Viral; Central Nervous System Diseases; Chickenpox; Child; Herpesvirus 3, Human; Humans; Leukopenia; Liver Diseases; Male; Neutropenia

1988
[Minor symptoms in family practice; herpes zoster].
    Nederlands tijdschrift voor geneeskunde, 1988, Jul-02, Volume: 132, Issue:27

    Topics: Acyclovir; Chickenpox; Diagnosis, Differential; Family Practice; Herpes Zoster; Herpesviridae Infections; Humans

1988
Use of acyclovir to treat chickenpox in pregnancy.
    British medical journal (Clinical research ed.), 1988, Feb-06, Volume: 296, Issue:6619

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pregnancy; Pregnancy Complications, Infectious

1988
Chickenpox in pregnancy.
    British medical journal (Clinical research ed.), 1988, Mar-19, Volume: 296, Issue:6625

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pregnancy; Pregnancy Complications, Infectious

1988
[Diagnosis and therapy of varicella encephalitis].
    Minerva pediatrica, 1988, Volume: 40, Issue:5

    Topics: Acyclovir; Adolescent; Adrenal Cortex Hormones; Chickenpox; Child; Child, Preschool; Encephalitis; Female; Humans; Male

1988
Chickenpox pneumonia: experience with antiviral treatment.
    Thorax, 1988, Volume: 43, Issue:8

    Of 13 patients with chickenpox pneumonia (12 of them adults) treated during 1979-87, 10 received antiviral drugs--nine acyclovir and one vidarabine. Three died despite intensive treatment. Serious secondary infections occurred in six cases. There were no clear indications that antiviral treatment altered the natural history of the condition. Acyclovir may at present be used too late in the course of chickenpox pneumonia to alter its outcome.

    Topics: Acyclovir; Adolescent; Adult; Bacterial Infections; Chickenpox; Female; Humans; Lung; Male; Middle Aged; Pneumonia, Viral; Radiography; Vidarabine

1988
Continuous varicella-zoster infection associated with acyclovir resistance in a child with AIDS.
    JAMA, 1988, Nov-18, Volume: 260, Issue:19

    Acyclovir has become the treatment of choice for varicella-zoster virus (VZV) infections in immunocompromised individuals. This article describes a 4-year-old girl congenitally infected with human immunodeficiency virus who developed a continuous cutaneous infection with VZV that persisted over a 14-month period until her death. Initial episodes of varicella and zoster were responsive to acyclovir treatment; however, subsequent recurrences necessitated administration of multiple courses of acyclovir. Lesions became markedly hyperkeratotic, slow healing, and persistent despite acyclovir therapy. Numerous attempts to isolate virus from the lesions yielded only one isolate late in the course of therapy. This virus clearly demonstrated acyclovir resistance in vitro. Bizarre manifestations of VZV infection could present both diagnostic and therapeutic dilemmas. Prolonged acyclovir treatment of highly immunocompromised patients with acquired immunodeficiency syndrome and severe VZV may lead to the appearance of resistant virus.

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Chickenpox; Child, Preschool; Drug Administration Schedule; Drug Resistance, Microbial; Female; Herpes Zoster; Humans; Immunization, Passive

1988
[Prevention of chickenpox after contagium in immunodepressed children. Evaluation of the possible role of acyclovir].
    Archives francaises de pediatrie, 1988, Volume: 45, Issue:8

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Humans; Immunologic Deficiency Syndromes; Infant

1988
[Varicella infection in patients with acute lymphocytic leukemia].
    Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 1988, Volume: 42, Issue:5

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Female; Humans; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma

1988
Varicella pneumonia during pregnancy. Treatment of two cases with acyclovir.
    American journal of perinatology, 1988, Volume: 5, Issue:1

    Pneumonia is a rare but serious complication of varicella during pregnancy. Maternal mortality has been reported to be 41% with fetal and neonatal mortality at 65%. Treatment has included respiratory support and prophylactic antibiotics. Acyclovir has been prescribed with the intent to decrease the impact of the infection. It was added to the treatment protocol of two cases of varicella pneumonia in pregnancy. Despite the high maternal and perinatal mortality both pairs of patients and infants survived. Acyclovir did not appear to adversely influence the fetus, and may have contributed to the survival of mother and child.

    Topics: Acyclovir; Adolescent; Adult; Chickenpox; Combined Modality Therapy; Drug Therapy, Combination; Female; Humans; Infant, Newborn; Pneumonia, Viral; Positive-Pressure Respiration; Pregnancy; Pregnancy Complications, Infectious

1988
Antiviral treatment in chickenpox and herpes zoster.
    Journal of the American Academy of Dermatology, 1988, Volume: 18, Issue:1 Pt 2

    Intravenous acyclovir is effective for varicella in adults and immunocompromised children, causing more rapid resolution of the illness and fewer complications. Intravenous acyclovir in immunocompromised patients with herpes zoster decreases new lesion formation, decreases acute pain, halts dissemination of the virus, and lessens visceral complications. Intravenous acyclovir may also be effective in zoster encephalitis. Intravenous vidarabine also has a favorable affect on chickenpox and herpes zoster. Topical acyclovir may benefit herpes zoster in immunosuppressed patients by accelerating cutaneous healing. Oral acyclovir appears to be effective in varicella and zoster in immunocompromised patients. It is also effective in otherwise normal patients, but its effect seems less dramatic and the drug must be given early. Neither acyclovir nor vidarabine has been proven clearly to prevent postherpetic neuralgia. Because varicella zoster virus is less sensitive to acyclovir than is herpes simplex, intravenous doses of 500 mg/m2 or 10 mg/kg every 8 hours or oral doses of 800 mg five times a day are recommended. At these doses adequate hydration and urine flow must be maintained, the mental status of the patient must be monitored, and impaired renal function requires regulation of dosage downward.

    Topics: Acyclovir; Adult; Chickenpox; Child; Herpes Zoster; Humans; Immunotherapy; Vidarabine

1988
Varicella pneumonia.
    Archives of internal medicine, 1988, Volume: 148, Issue:7

    Six normal adults with varicella pneumonia were treated successfully with acyclovir sodium. All patients showed resolution of roentgenographic and arterial blood gas abnormalities. In addition, five of the six patients demonstrated thrombocytopenia that resolved with therapy. Intravenous acyclovir therapy should be instituted as early as possible in patients who may have varicella pneumonia.

    Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Chickenpox; Female; Humans; Injections, Intravenous; Male; Pneumonia, Viral

1988
Acute retinal necrosis syndrome following chickenpox in pregnant woman.
    Japanese journal of ophthalmology, 1988, Volume: 32, Issue:1

    A pregnant woman presented with acute retinal necrosis syndrome (ARNS) involving both eyes. She had had varicella eruption one month before the onset of the disease. Antibody titer to the varicella-zoster virus was elevated in the aqueous humor of both eyes. To our knowledge, this is the first report which showed apparent association of varicella eruption with ARNS caused by varicella-zoster virus.

    Topics: Acyclovir; Adult; Chickenpox; Female; Fundus Oculi; Humans; Necrosis; Ophthalmoscopy; Prednisolone; Pregnancy; Pregnancy Complications; Retinal Diseases; Syndrome

1988
Fatal varicella in an adult.
    Cutis, 1988, Volume: 42, Issue:2

    Chickenpox (varicella) is generally considered a childhood disease. Although adults account for only 1.5 percent of patients affected, they account for 27.6 percent of total deaths. We report on a 25-year-old white man who died of varicella. We hope that this report will alert the physician to the serious nature of primary varicella infection in adults.

    Topics: Acyclovir; Adult; Chickenpox; Humans; Male; Sepsis; Staphylococcal Infections

1988
Herpes virus infections after orthotopic liver transplantation.
    Transplantation proceedings, 1987, Volume: 19, Issue:5

    Topics: Acyclovir; Blood Donors; Chickenpox; Cytomegalovirus Infections; Herpes Simplex; Herpesviridae Infections; Humans; Liver Transplantation; Opportunistic Infections; Time Factors; Tissue Donors

1987
Ribonucleotide reductase induced by varicella zoster virus. Characterization, and potentiation of acyclovir by its inhibition.
    Biochemical pharmacology, 1987, Dec-15, Volume: 36, Issue:24

    An enzyme that catalyzes the conversion of CDP to 2'-dCDP in the presence of dithiothreitol (DTT) was detected in ammonium sulfate fractionated-extracts of varicella zoster virus (VZV)-infected cells. This ribonucleotide reductase was antigenically distinguishable from the isofunctional eucaryotic enzyme as well as the ribonucleotide reductases induced by herpes simplex virus types 1 and 2 (HSV-1 and HSV-2). The VZV-induced enzyme was purified to the extent that most of the contaminating enzymes, which would significantly deplete the substrate, were removed. The VZV-induced ribonucleotide reductase exhibited maximum activity in the absence of ATP and/or magnesium and was only weakly inhibited by 2'-deoxynucleoside triphosphates. Furthermore, ADP, UDP and GDP competitively inhibited CDP reduction with Ki (Km) values of 15, 20, 1.8 and 0.88 microM, respectively. These kinetic properties were very similar to those of the correspondingly purified ribonucleotide reductases induced by HSV-1 [Averett et al., J. biol. Chem. 258, 9831 (1983)] and HSV-2 [Averett et al., J. Virol. 52, 981 (1984)] and were dissimilar to the allosterically regulated mammalian enzyme. A723U, an inactivator of HSV-1 ribonucleotide reductase that potentiates the anti-HSV-1 activity of acyclovir [Spector et al., Proc. natn. Acad. Sci. U.S.A. 82, 4254 (1985)], also appeared to inactivate this VZV-induced ribonucleotide reductase and to potentiate the anti-VZV activity of acyclovir.

    Topics: Acyclovir; Cells, Cultured; Chickenpox; Cytidine Diphosphate; Drug Synergism; Enzyme Induction; Herpesvirus 3, Human; Humans; Immunologic Techniques; Kinetics; Pyridines; Ribonucleotide Reductases; Thiosemicarbazones; Virus Replication

1987
Acyclovir in prophylaxis and perinatal varicella.
    Lancet (London, England), 1987, Jan-17, Volume: 1, Issue:8525

    Topics: Acyclovir; Chickenpox; Female; Herpesvirus 3, Human; Humans; Immunoglobulins; Infant, Newborn; Male; Pregnancy

1987
Effect of 9-(1,3-dihydroxy-2-propoxymethyl)guanine and recombinant human beta interferon alone and in combination on simian varicella virus infection in monkeys.
    The Journal of infectious diseases, 1987, Volume: 156, Issue:4

    Treatment of viral infections with combinations of antiviral agents may permit administration of reduced doses of either or both drugs. Lowered doses may reduce associated toxicity. Intravenous administration of substantial doses of either human recombinant beta interferon (rHuIFN-beta) or 9-(1,3-dihydroxy-2-propoxymethyl)guanine (DHPG) prevents development of simian varicella virus infection in African green monkeys. Daily doses of 2 X 10(6) U of rHuIFN-beta/kg inhibited clinical disease in monkeys inoculated with simian varicella virus, and doses of DHPG between 20 and 60 mg/kg per day were necessary for similar antiviral effects. Intravenous administration of combinations of rHuIFN-beta and DHPG permitted an approximately 100-fold reduction in the effective dose of rHuIFN-beta and a 10-fold reduction in the effective dose of DHPG. Analysis of data relating to viremia by using the method of the median-effect principle showed the combination of rHuIFN-beta and DHPG was strongly synergistic in treatment of this infection.

    Topics: Acyclovir; Animals; Antibodies, Viral; Antiviral Agents; Chickenpox; Chlorocebus aethiops; Drug Therapy, Combination; Ganciclovir; Herpesvirus 3, Human; Interferon Type I; Recombinant Proteins; Software; Time Factors; Viremia

1987
Chickenpox in adult renal transplant recipients.
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 1987, Volume: 1, Issue:4

    Five of 610 adults developed chickenpox between 35 days and 9.2 years after renal transplantation, and only one patient survived. All patients received prednisolone and azathioprine during the incubation period. Corticosteroid therapy was continued, but azathioprine was stopped after diagnosis. Four patients were treated with acyclovir, but three were given suboptimal doses. The patient who survived had been taking the lowest dose of azathioprine and was given the recommended dose of acyclovir. All patients who died developed disseminated intravascular coagulation, and at postmortem examination were found to have had cerebral haemorrhage. None of the patients treated with acyclovir had evidence of active varicella-zoster virus infection at post-mortem examination, but two had disseminated bacterial and fungal infections. Chickenpox follows a severe and often fatal course in adults with renal transplants. Prompt acyclovir therapy can be effective, provided an adequate dose is given. Attention should be directed towards prevention by the identification and immunisation of at risk patients prior to transplantation.

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Risk

1987
Acyclovir therapy of severe chickenpox in an adult renal transplant patient.
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 1987, Volume: 2, Issue:5

    Topics: Acute Disease; Acyclovir; Chickenpox; Humans; Kidney Transplantation; Male; Middle Aged

1987
Treatment and prognosis of chickenpox in adult renal transplant recipients on cyclosporin.
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 1987, Volume: 2, Issue:5

    Topics: Acyclovir; Adult; Chickenpox; Cyclosporins; Female; Humans; Kidney Transplantation; Prognosis

1987
Acyclovir in the treatment of primary varicella pneumonia in non-immunocompromised adults.
    New York state journal of medicine, 1987, Volume: 87, Issue:4

    Topics: Acyclovir; Adult; Chickenpox; Humans; Middle Aged; Pneumonia, Viral

1987
Special aspects of supportive therapy in childhood acute leukemias.
    Haematology and blood transfusion, 1987, Volume: 30

    Topics: Acyclovir; Antineoplastic Combined Chemotherapy Protocols; Blood Transfusion; Chickenpox; Child; Female; Herpes Zoster; Humans; Immunization, Passive; Immunosuppression Therapy; Leukemia, Lymphoid; Male; Prospective Studies; Random Allocation; Remission Induction

1987
Infantile herpes zoster ophthalmicus and acute hemiparesis following intrauterine chickenpox.
    Neurology, 1987, Volume: 37, Issue:9

    A 17-month-old boy developed herpes zoster ophthalmicus (HZO) and delayed contralateral hemiparesis following intrauterine varicella exposure. CT demonstrated multiple areas of hypodensity in the left basal ganglia, and angiography showed occlusion of left lenticulostriate arteries. As in most adults with HZO and delayed hemiparesis, this infant had a self-limiting course with excellent recovery.

    Topics: Acyclovir; Basal Ganglia; Chickenpox; Female; Hemiplegia; Herpes Zoster Ophthalmicus; Humans; Infant; Male; Pregnancy; Pregnancy Complications, Infectious; Prenatal Exposure Delayed Effects; Radiography

1987
Varicella pneumonia in adulthood: acyclovir therapy may be of benefit.
    Annals of emergency medicine, 1987, Volume: 16, Issue:9

    Topics: Acyclovir; Adult; Chickenpox; Humans; Male; Pneumonia, Viral

1987
[Acute respiratory distress syndrome in chickenpox in 3 healthy adults].
    Annales de medecine interne, 1987, Volume: 138, Issue:4

    Three adults previously in good health developed pulmonary oedema during chickenpox. Severe hypoxemia required mechanical ventilation. All patients recovered without extensive pulmonary sequela on the first month pulmonary functional test. The severity of adult chickenpox requires hospitalization for treatment with Acyclovir.

    Topics: Acute Disease; Acyclovir; Adult; Chickenpox; Humans; Male; Respiratory Distress Syndrome

1987
Acyclovir in the treatment of neonatal varicella.
    The Journal of infection, 1987, Volume: 15, Issue:1

    We describe two cases of neonatal varicella and the role of acyclovir in their treatment.

    Topics: Acyclovir; Chickenpox; Female; Humans; Infant, Newborn; Male

1987
[Treatment of congenital varicella with acyclovir].
    Monatsschrift Kinderheilkunde : Organ der Deutschen Gesellschaft fur Kinderheilkunde, 1987, Volume: 135, Issue:10

    We describe three newborns who developed varicella six hours, five or eight days after delivery. Because of the high lethality rate of congenital varicella treatment with acyclovir appeared to be indicated. Acyclovir was administered intravenously in a dosage of 3 X 5, 3 X 7.5, and 3 X 10 mg/kg/day for three to five days. All patients showed prompt clinical improvement and the skin lesions disappeared. Side effects were not observed. Dependent on the dosage radioimmunological determination of acyclovir serum levels revealed basic values between less than 0.34 to 13.9 mumol/l; peak levels ranged from 14.0 to 70.2 mumol/l. Our preliminary results demonstrate that acyclovir can be successfully used to treat congenital varicella. A dosage of at least 3 X 7.5 mg/kg/day is recommended.

    Topics: Acyclovir; Chickenpox; Combined Modality Therapy; Humans; Immunization, Passive; Infant, Newborn; Risk Factors

1987
Acyclovir treatment of varicella pneumonia in pregnancy.
    Critical care medicine, 1987, Volume: 15, Issue:4

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious

1987
Varicella and herpes zoster infections in immunocompromised host: prevention and treatment.
    Boletin de la Asociacion Medica de Puerto Rico, 1986, Volume: 78, Issue:4

    Topics: Acyclovir; Antibody Formation; Chickenpox; Disease Susceptibility; gamma-Globulins; Herpes Zoster; Humans; Immunity, Cellular; Immunologic Deficiency Syndromes; Interferons; Risk; Vidarabine; Virus Activation

1986
Antiviral therapy. New drugs and their uses.
    Postgraduate medicine, 1986, Volume: 80, Issue:1

    Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Amantadine; Antiviral Agents; Chickenpox; Common Cold; Cytomegalovirus Infections; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Influenza, Human; Interferons; Ribavirin; Rimantadine; Thymidine; Vidarabine; Virus Diseases; Zidovudine

1986
[Experiences with acyclovir in herpes virus infections].
    Wiener klinische Wochenschrift, 1986, Jan-10, Volume: 98, Issue:1

    46 patients suffering from various malignancies (17 non Hodgkin lymphomas, 12 Hodgkin's diseases, 11 acute leukaemias, 4 myelomas, 2 carcinomas), 6 patients with haematological disorders such as ITP, SAA, myeloproliferative disease, LAS and 3 patients without preexisting disease were treated with acyclovir for herpes virus infection diagnosed by clinical means. All but 7 patients had been given intensive treatment with various cytostatic agents and/or irradiation. Most patients were treated with 1500 mg acyclovir daily for 5 to 13 days. Dosage was adjusted according to renal function and clinical response in the remaining 10 cases. 11 patients received intravenous immunoglobulins in addition. Side effects were negligible (local irritation, minimal rise in serum creatinine levels in 5 patients). All patients responded to treatment; 6 patients complained of severe neuralgia lasting for more than one month; 5 patients relapsed.

    Topics: Acute Disease; Acyclovir; Adolescent; Adult; Aged; Chickenpox; Combined Modality Therapy; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Hodgkin Disease; Humans; Keratitis, Dendritic; Leukemia; Lymphoma; Male; Middle Aged; Tumor Virus Infections

1986
Acyclovir in the treatment of infection due to herpes viruses.
    Czechoslovak medicine, 1986, Volume: 9, Issue:4

    Intravenous infusions of acyclovir were administered to 15 patients suffering from herpes simplex or varicella-zoster infections. The therapeutic effect of the drug consisted in rapid cessation of progression of the disease and in considerable shortening of duration of clinical symptoms. There were no adverse reaction in our groups of patients. There were no relapses after the treatment with acyclovir had been stopped. From what has been stated above, we take acyclovir for a highly efficient and safe drug for therapy of HSV and VZV infections.

    Topics: Acyclovir; Adult; Chickenpox; Child; Child, Preschool; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Infant

1986
Short-time and low-dose intravenous acyclovir therapy in varicella zoster infections with malignant disease in children receiving combined chemotherapy.
    Pediatric hematology and oncology, 1986, Volume: 3, Issue:3

    The effects of low-dose and short-time acyclovir therapy in 14 children with malignant disease of ages 4-18 years who had developed varicella zoster virus infections while receiving aggressive chemo-/+radiotherapy are reported. Ten of them had chickenpox and 4 herpes zoster. Acyclovir 5 mg/kg was infused IV every 12 h in 9 patients and every 8 h in 5 patients for a median of 4 days' duration. We resumed the primary therapy when the patients' lesions had dried out and became crusted and new lesions had not reappeared. The period of initiation of the acyclovir therapy to the resumption of oncological treatment was 8.4 +/- 2.7 days for chickenpox and 12.0 +/- 3.4 days for herpes zoster patients. After restarting the oncological therapy, no adverse effects of acyclovir or complication of infection were observed. The efficiency of early, short-term, and relatively low dose acyclovir therapy is discussed and compared to the results in the relevant literature.

    Topics: Acyclovir; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Chickenpox; Child; Child, Preschool; Drug Evaluation; Female; Herpes Zoster; Humans; Male; Neoplasms

1986
Optic neuritis following chickenpox in adults.
    Journal of neurology, 1986, Volume: 233, Issue:3

    Three cases of bilateral optic neuritis, one of which also had transverse myelitis, are described in young adults following chickenpox. Severe bilateral loss of vision developed in all cases and was followed by good visual recovery in the two with isolated optic neuritis, but poor recovery in the patient with concomitant transverse myelitis. The interval between the initial rash and subsequent optic neuritis suggests an immunological pathogenesis for this complication.

    Topics: Acyclovir; Adult; Chickenpox; Dexamethasone; Female; Humans; Male; Myelitis, Transverse; Optic Neuritis; Prednisone; Vision Disorders

1986
Varicella-zoster infection in pregnancy.
    The New England journal of medicine, 1986, Nov-27, Volume: 315, Issue:22

    Topics: Acyclovir; Adult; Chickenpox; Congenital Abnormalities; Female; Humans; Pregnancy; Pregnancy Complications, Infectious

1986
Treatment of herpesvirus infections in the immunocompromised host.
    Scandinavian journal of infectious diseases. Supplementum, 1985, Volume: 47

    Major advances have been made in the treatment of herpesvirus infections in the compromised host. Acyclovir is clearly effective in the treatment of HSV infection, and preferable to vidarabine for this purpose. Additional information about the optimal use of acyclovir for treatment or prophylaxis and about the ultimate significance of the phenomena of acyclovir resistance and possible suppression of the specific immune response are needed. The major challenge at this time is the rapid clinical or virologic diagnosis of HSV infection, especially the rarer manifestations such as HSV pneumonia or encephalitis, so that effective therapy can be initiated. The serious manifestations of VZV infection (e.g. cutaneous and visceral dissemination) can also be controlled with either vidarabine or acyclovir, although definition of the agent of choice is still lacking. More information is needed to define the relative efficacy of acyclovir compared with vidarabine, and also to define better treatment regimens for the prevention of post-herpetic neuralgia which remains a major source of morbidity. Use of either oral or topical acyclovir and anti-inflammatory agents in combined regimens is being studied. Interferon, although effective, has little present role in view of the availability of both acyclovir and vidarabine, although it is of interest as a model of an agent that can be administered to outpatients or used in synergistic regimens. The challenge for treatment of CMV is the development of an agent which is effective in vivo. Several promising agents are on the horizon, but much initial work must be done before their effectiveness will become apparent.(ABSTRACT TRUNCATED AT 250 WORDS)

    Topics: Acyclovir; Administration, Oral; Bone Marrow Transplantation; Chickenpox; Cytomegalovirus Infections; Drug Resistance, Microbial; Herpes Simplex; Herpes Zoster; Humans; Immune Tolerance; Immunity; Interferons; Vidarabine

1985
Intravenous acyclovir for herpesvirus in immunocompromised patients.
    Israel journal of medical sciences, 1985, Volume: 21, Issue:1

    Severe herpesvirus infections in 18 immunocompromised patients (25 episodes) were treated with i.v. acyclovir. Six patients had 13 episodes of mucocutaneous herpes simplex infections, eight children had varicella, three patients had generalized zoster, and one patient had cytomegalovirus pneumonia. No patient died from infections. In 18 episodes treatment with acyclovir produced a beneficial effect, in 5 episodes acyclovir was probably beneficial, and in 2 patients the effect could not be evaluated. No serious side effects could be definitely attributed to acyclovir administration. These data support the previous experience that i.v. acyclovir may be useful in the treatment of herpesvirus infections in immunocompromised patients.

    Topics: Acyclovir; Adult; Aged; Chickenpox; Child; Child, Preschool; Cytomegalovirus Infections; Drug Evaluation; Female; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Immunologic Deficiency Syndromes; Infant; Infusions, Parenteral; Male; Middle Aged

1985
Acyclovir treatment of disseminated varicella in childhood malignant neoplasms.
    American journal of diseases of children (1960), 1985, Volume: 139, Issue:2

    Primary varicella-zoster virus infection (chickenpox) in immunocompromised children is frequently associated with visceral dissemination and attendant high mortality. Eight children with malignant neoplasms and chickenpox with visceral involvement (seven with hepatitis, three with pneumonitis, two with encephalitis, and two with coagulopathy) were initially treated with intravenously (IV) administered vidarabine but demonstrated progressive visceral involvement. After three days of vidarabine treatment (two days for two patients), seven had rising serum SGPT levels, all eight had pneumonitis, seven had deteriorating mental status and/or seizure activity, and six had worsening coagulopathy. Vidarabine was replaced by IV administered acyclovir, with subsequent improvement in all but the most severely ill patient who died. Seven of eight patients recovered completely; no side effects of acyclovir were observed. This clinical experience suggests that acyclovir may be more effective than vidarabine in disseminated varicella infection; however, controlled clinical trials will be necessary to establish this.

    Topics: Acyclovir; Blood Coagulation Disorders; Chickenpox; Child; Encephalitis; Female; Hepatitis, Viral, Human; Humans; Leukemia, Lymphoid; Lymphatic Diseases; Male; Pneumonia, Viral; Vidarabine

1985
[Acyclovir in the treatment of viral complications in patients with leukemia].
    Polski tygodnik lekarski (Warsaw, Poland : 1960), 1985, Feb-11, Volume: 40, Issue:6

    Topics: Acyclovir; Chickenpox; Child; Child, Preschool; Female; Herpes Simplex; Humans; Leukemia, Lymphoid; Male

1985
Rash, cough, and chest pain in a young man.
    Hospital practice (Office ed.), 1985, May-30, Volume: 20, Issue:5A

    Topics: Acyclovir; Adult; Chickenpox; Humans; Male; Pneumonia, Viral

1985
[Successful intravenous Zovirax/acyclovir therapy in a case of adult varicella progressiva complicated by extensive bilateral pneumonia].
    Orvosi hetilap, 1985, Jul-07, Volume: 126, Issue:27

    Topics: Acyclovir; Adult; Age Factors; Chickenpox; Humans; Injections, Intravenous; Male; Pneumonia, Viral

1985
[Antiviral therapy of immunocompromised patients].
    Immunitat und Infektion, 1984, Volume: 12, Issue:4

    For immunocompromised patients virus infections represent a definite risk, particularly infections with measles virus and viruses of the herpes group (primary infections or reactivations). Vidarabine, acyclovir and bromovinyldeoxyuridine are therapeutically active against varicella, zoster, and herpes simplex, provided they are administered early in the course of disease. For zoster at least, the efficacy of interferon has been documented in controlled studies. No convincing therapy is so far available for the severe cytomegalovirus infections. Interferons obtained with DNA recombinant techniques are of significant promise in the near future.

    Topics: Acyclovir; Antiviral Agents; Bromodeoxyuridine; Chickenpox; Cytomegalovirus Infections; Herpes Simplex; Herpes Zoster; Humans; Immune System Diseases; Vidarabine; Virus Diseases

1984
[Acyclovir therapy in varicella/zoster diseases in immunocompromised children with cancer].
    Monatsschrift Kinderheilkunde : Organ der Deutschen Gesellschaft fur Kinderheilkunde, 1984, Volume: 132, Issue:2

    21 patients, aged 1 to 15 years, who developed manifest varicella/zoster-virus infection while on chemotherapy for malignant disease were treated with acyclovir. Drug dosage was 10 mg/kg every eight hours for 5 days as a one hour infusion. The clinical course of the infection in all patients was mild. 1 to 4 (median 2,2) days after beginning of acyclovir therapy the formation of new lesions stopped. Within 4 to 8 (median 5,9) days all vesicles were scabbed . In 13 patients with fever in the beginning the temperature fell within 2 to 6 (median 2,6) days of treatment. The development of visceral involvement was not observed during or after acyclovir therapy. Acyclovir was well tolerated. Tests of the hematopoietic, liver and renal functions before and after acyclovir therapy revealed no adverse effects of the drug. Also the immunologic response seemed not to be impaired. With one exception, all patients investigated had antibodies against varicella/zoster-virus after recovery. In order to prevent varicella infection after household exposure two immunocompetent patients were treated prophylactically with acyclovir tablets (400 mg 5 times a day for 5 days). Both children did not exhibit manifest varicella/zoster infection, but five weeks later they had antibodies against varicella/zoster-virus (KBR 1:10, resp. KBR 1:20).

    Topics: Acyclovir; Adolescent; Adult; Antibodies, Viral; Antineoplastic Combined Chemotherapy Protocols; Chickenpox; Child; Child, Preschool; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunosuppression Therapy; Infant; Liver Function Tests; Neoplasms

1984
Acyclovir therapy for chickenpox in children with hematological malignancies.
    European journal of pediatrics, 1984, Volume: 142, Issue:2

    Nineteen immunocompromised children with varicella were given intravenous acyclovir in dosages of 1000-1500 mg/m2 per day every 8 h for 5-10 days. The effect of treatment was compared with data from a group of patients previously treated with arabinoside cytosine (ara-c). The median times to cessation of new lesion formation, lesion crusting and lesion healing were shorter in the acyclovir-treated group than for ara-c. The time-to-event probability curves for cessation of new lesion formation, lesion crusting and lesion healing were significantly different for the acyclovir and ara-c group. Patients receiving acyclovir experienced no major adverse effects. Anticancer therapy did not require modification in most cases treated with acyclovir. Acyclovir was highly effective and nontoxic when used in the treatment of varicella-zoster infections in children with hematological malignancies being given anticancer treatment in comparison with ara-c therapy.

    Topics: Acyclovir; Adolescent; Chickenpox; Child; Child, Preschool; Cytarabine; Female; Humans; Infant; Lymphoproliferative Disorders; Male

1984
Acyclovir and varicella pneumonia.
    South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1984, Oct-06, Volume: 66, Issue:14

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Pneumonia, Viral

1984
Severe acute encephalitis--improved outcome after barbiturate treatment?
    Scandinavian journal of infectious diseases, 1984, Volume: 16, Issue:1

    Six cases of severe encephalitis due to measles, varicellae, mononucleosis, influenza, rubella and pertussis were treated with high doses of barbiturates in combination with steroids and artificial hyperventilation. Four of the patients also received antiviral therapy. They all survived without neurological sequelae. The use of barbiturates in high doses may be of importance for an improved outcome in patients with severe encephalitis.

    Topics: Acyclovir; Adult; Chickenpox; Child; Combined Modality Therapy; Dexamethasone; Encephalitis; Female; Humans; Infant; Infectious Mononucleosis; Influenza, Human; Male; Measles; Middle Aged; Phenobarbital; Respiration, Artificial; Whooping Cough

1984
Acyclovir administered perorally in immunocompromised children with varicella-zoster infections.
    The Journal of infectious diseases, 1984, Volume: 149, Issue:3

    Topics: Acyclovir; Administration, Oral; Adolescent; Chickenpox; Child; Female; Herpes Zoster; Humans; Immune Tolerance; Male; Neoplasms

1984
Varicella-zoster infections. Advances in the prevention and treatment.
    Minnesota medicine, 1983, Volume: 66, Issue:10

    Topics: Acyclovir; Adult; Chickenpox; Child; Herpes Zoster; Humans; Interferons; Vidarabine

1983
Prolonged excretion of herpesvirus varicellae in a child with acute lymphoblastic leukaemia.
    The Journal of infection, 1983, Volume: 6, Issue:3

    An eight-year-old girl with acute lymphoblastic leukaemia (ALL) in remission presented with varicella. Zoster immune globulin was not given, but treatment with acyclovir was commenced the day after presentation and continued for five days. Many of the original vesicles ulcerated and persisted for periods in excess of three months, finally leaving residual scarring. Further new vesicles appeared at 80 days and 109 days, and virus was again visualised by electron microscopy. Seroconversion was not demonstrated, although the child has in the past responded serologically to other viruses. A series of other infections afflicting the child at about the same time is documented and the possible implications are discussed.

    Topics: Acyclovir; Chickenpox; Child; Female; Herpesvirus 3, Human; Humans; Leukemia, Lymphoid; Recurrence; Time Factors

1983
[Varicella-zoster virus infections in the immunosuppressed child. Treatment with Acyclovir and controls].
    Archives francaises de pediatrie, 1983, Volume: 40, Issue:2

    Sixty minutes intravenous infusions of Acyclovir were given at 5 to 10 mg/kg 3 times daily for 6 to 11 days in 20 immunodeficient children with varicella (9 cases) and herpes zoster (11 cases) in a controlled open study. Twelve patients had a life-threatening illness. All patients who received therapy before the first 4 days had a more rapid cessation of new vesicles formation and more rapid scarring. Fourteen controlled children had accelerated clearance of viral antigens from vesicles. In 19 cases, virus was no longer isolated after the 3rd day. Eighteen patients recovered within 6 to 10 days. No relapse of varicella zoster virus infections had been observed 1 to 18 months after the end of treatment. Two children with varicellous interstitial pneumonia died 8 and 32 days after the end of treatment. In 3 cases, zoster pains reappeared 8 days after Acyclovir therapy was stopped. The drug was well-tolerated, but control of renal functions is necessary.

    Topics: Acyclovir; Adolescent; Antigens, Viral; Chickenpox; Child; Child, Preschool; Female; Fluorescent Antibody Technique; Herpes Zoster; Humans; Immune Tolerance; Infusions, Parenteral; Leukemia; Lymphoma; Male; Neoplasms

1983
[Acyclovir in severe varicella pneumonia and in herpes ophthalmicus].
    Schweizerische Rundschau fur Medizin Praxis = Revue suisse de medecine Praxis, 1983, Sep-13, Volume: 72, Issue:37

    Topics: Acyclovir; Adult; Chickenpox; Female; Humans; Keratitis, Dendritic; Male; Pneumonia, Viral

1983
[Intravenous acyclovir (ACV, Zovirax) therapy of varicella zoster infections in immunologically endangered patients].
    Orvosi hetilap, 1983, Nov-27, Volume: 124, Issue:48

    Topics: Acyclovir; Adolescent; Adult; Aged; Chickenpox; Child; Child, Preschool; Female; Herpes Zoster; Humans; Immunologic Deficiency Syndromes; Male; Middle Aged; Prognosis; Risk

1983
Vasculitis in association with chickenpox treatment in childhood acute lymphoblastic leukemia.
    Lancet (London, England), 1982, Oct-02, Volume: 2, Issue:8301

    Topics: Acyclovir; Chickenpox; Child; Guanine; Herpes Zoster; Humans; Immunization, Passive; Immunosuppression Therapy; Leukemia, Lymphoid; Male; Vasculitis

1982
Acyclovir in the treatment of simian varicella virus infection of the African green monkey.
    The American journal of medicine, 1982, Jul-20, Volume: 73, Issue:1A

    Acyclovir (9-(2-hydroxyethoxymethyl)guanine) administered as an intramuscular formulation twice daily at a dosage of 100 mg/kg per day prevented the development of disease in African green monkeys inoculated with simian varicella virus. Viremia, appearance of a vesicular rash, and elevations of serum transaminases, each indicative of infection, were suppressed by acyclovir treatment. Plasma concentrations of acyclovir were measured and showed rising levels after repeated intramuscular injection with a prolonged period of absorption of acyclovir into the plasma circulation. Investigation of antiviral efficacy after either intramuscular or intravenous acyclovir treatment showed both routes of administration to be effective in inhibiting simian varicella virus infection at the 100 mg/kg per day level. However, intravenous acyclovir 50 mg/kg twice daily did result in elevated values of blood urea nitrogen, creatinine, and serum transaminases.

    Topics: Acyclovir; Animals; Antibodies, Viral; Antiviral Agents; Chickenpox; Chlorocebus aethiops; Drug Evaluation, Preclinical; Guanine; Herpesvirus 3, Human; Injections, Intramuscular; Injections, Intravenous; Viremia

1982
Acyclovir in severe herpes virus infections.
    The American journal of medicine, 1982, Jul-20, Volume: 73, Issue:1A

    Forty-five patients with severe herpes virus infections were treated with acyclovir intravenously for five days. Nine patients had varicella (eight of whom were immuno- or myelocompromised), 23 had herpes zoster (14 compromised patients) and 13 had herpes simplex (nine compromised patients). No patient died from the viral infection and in eight of the patients the beneficial effect of acyclovir was beyond doubt. Six of these patients had herpes simplex infections. In 21 patients acyclovir was probably beneficial, whereas in 16 patients the effect was doubtful or absent. As expected, in patients with established neurologic damage there was no effect. Except for transient elevation in transaminases in one patient and occasional infusion thrombophlebitis, no toxicity of acyclovir was encountered in this series.

    Topics: Acyclovir; Adolescent; Adult; Aged; Antiviral Agents; Chickenpox; Child; Child, Preschool; Drug Evaluation; Female; Guanine; Herpes Labialis; Herpes Simplex; Herpes Zoster; Humans; Immune Tolerance; Keratitis, Dendritic; Male; Middle Aged

1982
Severe atypical recurrent varicella in childhood leukaemia.
    Lancet (London, England), 1981, Jan-17, Volume: 1, Issue:8212

    Topics: Acyclovir; Antibodies, Viral; Antineoplastic Agents; Antiviral Agents; Chickenpox; Child; Guanine; Humans; Leukemia, Lymphoid; Male

1981
[Experiences with intravenously administered acyclovir in severe herpesvirus infections].
    Nederlands tijdschrift voor geneeskunde, 1981, Nov-28, Volume: 125, Issue:48

    Topics: Acyclovir; Adolescent; Adult; Aged; Antiviral Agents; Chickenpox; Child; Child, Preschool; Drug Evaluation; Female; Guanine; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Humans; Infusions, Parenteral; Male; Middle Aged

1981
Acyclovir treatment of experimental simian varicella infection of monkeys.
    Antimicrobial agents and chemotherapy, 1981, Volume: 20, Issue:3

    Replication of simian varicella virus (SVV) in Vero cell cultures was inhibited by acyclovir, 9-(2-hydroxyethoxymethyl)guanine (ACV), at a concentration of 10 micrograms/ml in culture medium. Intravenous administration of ACV at 10 mg/kg twice a day for 10 days or 15 mg/kg three times a day for 5 days to patas monkeys (Erythrocebus patas) beginning 48 h after SVV inoculation blocked the appearance of rash and other clinical symptoms but did not affect viremia. ACV treatment of African green monkeys (Cercopithecus aethiops) at 10 mg/kg twice a day by intravenous injection beginning 24 or 72 h after SVV inoculation and continuing for 10 days had no effect on clinical symptoms, including the development of rash, or on the appearance of viremia. The minimal therapeutic results could be due to the observation that doses of 10 or 15 mg/kg produced plasma levels of ACV which were lower than 5 micrograms/ml, the concentration that inhibited SVV multiplication in vitro, and decayed rapidly.

    Topics: Acyclovir; Animals; Antiviral Agents; Cells, Cultured; Chickenpox; Chlorocebus aethiops; Erythrocebus patas; Female; Guanine; Male

1981
Treatment of chickenpox pneumonia with acyclovir.
    Lancet (London, England), 1980, Aug-30, Volume: 2, Issue:8192

    Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Female; Guanine; Humans; Pneumonia, Viral

1980
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