acyclovir and Colitis--Ulcerative

Topics: Abdominal Pain; Acyclovir; Aged; Biopsy, Needle; Colitis, Ulcerative; Female; Follow-Up Studies; Gastric Mucosa; Gastroscopy; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunohistochemistry; Infusions, Intravenous; Rare Diseases; Severity of Illness Index; Treatment Outcome; Viremia

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

Topics: Acyclovir; Antibodies, Monoclonal; Antiviral Agents; Colitis, Ulcerative; Colonic Pouches; Erythema Multiforme; Female; Gastrointestinal Agents; Herpes Simplex; Humans; Ileostomy; Immunosuppressive Agents; Infliximab; Proctocolectomy, Restorative; Simplexvirus; Treatment Outcome; Valacyclovir; Valine; Virus Activation; Young Adult

Topics: Acyclovir; Adolescent; Antiviral Agents; Colitis, Ulcerative; Herpes Simplex; Herpesvirus 1, Human; Humans; Ludwig's Angina; Male; Treatment Outcome

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

Topics: Acyclovir; Adult; Antiviral Agents; Cholangitis, Sclerosing; Colectomy; Colitis, Ulcerative; Hepatitis; Herpes Simplex; Humans; Liver Transplantation; Male; Postoperative Complications; Reoperation; Simplexvirus

Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Colitis, Ulcerative; Humans; Male

Our aim was to study the frequency, severity, and outcome of patients with Crohn's disease and ulcerative colitis treated with 6-mercaptopurine (6MP) who developed shingles during treatment, and to recommend management. While varicella can be severe in young people immunocompromised by steroids, the incidence of herpes zoster in older people with inflammatory bowel disease (IBD) and whether its severity is influenced by 6MP and azathioprine are unknown.. Data were collected from our IBD Center on 550 patients with IBD to identify those who developed shingles while on 6MP, its severity, the dose and duration of 6MP, and the management of the 6MP.. Twelve of 550 patients with IBD treated with 6MP developed shingles. In two with herpes zoster ophthalmicus the pain was prolonged, and one patient developed encephalitis which was brief and uncomplicated; in nine patients the course was benign. Acyclovir should be the treatment of choice even though it was available in only three cases.. Shingles occurs more often in IBD patients treated with 6MP than in those who are not, but the course is usually benign and there has been no mortality. The 6MP should be stopped temporarily until severity is established but if the underlying disease warrants further treatment the 6MP should be restarted.

Topics: Acyclovir; Adult; Aged; Antiviral Agents; Child; Colitis, Ulcerative; Crohn Disease; Female; Herpes Zoster; Humans; Immunosuppressive Agents; Incidence; Male; Mercaptopurine; Risk Factors; Severity of Illness Index

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

Topics: Acyclovir; Adult; Antiviral Agents; Colitis, Ulcerative; Herpes Simplex; Herpes Zoster; Humans; Male; Middle Aged

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