acyclovir and Diseases-in-Twins

Seventeen-day-old twins were hospitalized for neonatal herpes simplex virus 1 (HSV-1) with central nervous system disease and internal capsule and thalamic lesions on magnetic resonance imaging (MRI). They were treated with the usual intravenous (IV) treatment and oral therapy for 6 months. The clinical course was good in both children with negative HSV polymerase chain reaction on completion of IV therapy. The neurological condition recurred in one child with new radiological lesions at 7 months of age, 2 weeks after discontinuation of oral treatment. Cerebral lesions highlighted on the MRI scan are specific to the neonatal period and impact long-term prognosis. The likely genetic predisposition in this case is interesting and requires further investigation. In addition, this case raises questions about the duration of oral acyclovir suppressive therapy.

Topics: Acyclovir; Antiviral Agents; Central Nervous System Viral Diseases; Diseases in Twins; Electroencephalography; Female; Herpes Simplex; Herpesvirus 1, Human; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Recurrence

Topics: Acyclovir; Adult; Chickenpox; Diseases in Twins; Female; Humans; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Respiration, Artificial; Severity of Illness Index; Twins, Monozygotic

The Authors report a case of two pre-term monocorial twins affected by HSV-1 infection (Herpes Simplex Virus type 1), with generalized sepsis and involvement of the central nervous system (CNS), born by mother with primary infection who presented a typical vesicular eruption a week before delivery. As the HSV-1 was a disseminated type and the CNS was involved in both the twins, the diagnosis was based on clinical and laboratory findings (specific IgM and IgG) and on the use of Delpech-Lichtblau antibody liquoral index, a significant results both in the first and the second twin. Intensive care and early specific treatment with Acyclovir allowed a slow but progressive improvement of the twins' clinical picture. The antibody liquoral index may therapy of the viral sepsis cases involving the CNS, more than the cultural or antigen isolation of the treated virus.

Topics: Acyclovir; Adult; Antibodies; Diseases in Twins; Female; Herpes Simplex; Humans; Immunoglobulin G; Immunoglobulin M; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Infectious; Twins, Monozygotic

Multiple birth neonates are unique in sharing similar intrauterine, and commonly the extrauterine, environments. The development of an infectious disease in one infant during the perinatal period assumes special significance in this setting, and the other siblings are often at high risk for a similar disease. Under these circumstances it is important to make a rapid etiologic diagnosis to provide appropriate therapeutic intervention. The immediate, or "stat", autopsy is a diagnostic modality involving the use of multiple procedures for the rapid diagnosis of perinatal infection which may be lifesaving in the setting of multiple birth neonates. This report describes the use of the "stat" autopsy to diagnose a fatal case of disseminated herpes simplex infection in a twin, which lead to the immediate treatment of the surviving sibling with appropriate antiviral medication.

Topics: Acyclovir; Adult; Apgar Score; Autopsy; Diseases in Twins; Female; Herpes Simplex; Humans; Infant, Newborn; Respiratory Distress Syndrome, Newborn; Time Factors; Twins

Topics: Acyclovir; Adult; Diseases in Twins; Drug Therapy, Combination; Female; HIV Infections; HIV-1; Humans; Infant, Newborn; Infant, Premature, Diseases; Ketoconazole; Patient Compliance; Pregnancy; Pregnancy Complications, Infectious; Zidovudine

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