acyclovir and Exanthema

Neurological complications due to reactivation of varicella-zoster virus (VZV) are very uncommon in immunocompetent patients. Generally a vesicular rash is present on one or more dermatomes, preceding or following the main manifestation. Few cases are reported in the international literature, but they concern mainly adult or elderly patients.. A 12-year-old girl was referred to our hospital for persisting headache, cough and rhinitis for six days. After first examination, diagnosis of anterior sinusitis was made by nasal endoscopy. The day after, the girl developed psychotic symptoms and altered mental status. Computed tomography (CT) scan was immediately performed but was unremarkable; lumbar puncture revealed leukocytosis with lymphocytic predominance and cerebrospinal fluid polymerase chain reaction (PCR) detected varicella-zoster virus DNA. The diagnosis of acute VZV encephalitis was made. The patient was promptly treated with acyclovir infused intravenously and her clinical conditions rapidly improved. Tests made did not show any condition of immunosuppression.. Although if rare, reactivation of VZV can occur in immunocompetent children and its complications can involve central nervous system. Among these complications, meningitis is more common, but cerebral parenchyma can also be involved leading to a severe medical condition that is defined meningoencephalitis. In rare cases vesicular rash may be absent; therefore high level of suspicion is required even in those patients in which suggestive clinical features are not present to guide the diagnosis. Intravenous acyclovir represents the treatment of choice to obtain a fast clinical response and to prevent the onset of late-term complications.

Topics: Acyclovir; Adult; Aged; Child; Exanthema; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Meningoencephalitis

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

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

Oral acyclovir has become the standard of care for treatment of acute herpes zoster. Netivudine is a novel antiviral with greater in-vitro activity against varicella zoster virus. It was compared with acyclovir in a randomized, double-blind, controlled trial in immunocompetent adults with herpes zoster. Patients with rash for less than 72 h were assigned to receive either acyclovir or netivudine, then assessed regularly for 6 months. No evidence for a dose response with netivudine was found, so intent-to-treat analyses of all 511 enrolled patients compared acyclovir with netivudine. The time to complete cessation of pain (P = 0.007) and to cessation of moderate to excruciating pain (P = 0.005) was accelerated in acyclovir recipients. Rash outcomes and adverse event profiles were similar for both treatments. This study has confirmed the efficacy of acyclovir in decreasing the duration and severity of pain following herpes zoster. Greater in-vitro activity of newer agents may not necessarily provide greater benefit in humans.

Topics: Acyclovir; Aged; Antiviral Agents; Arabinofuranosyluracil; Double-Blind Method; Drug Administration Schedule; Exanthema; Female; Herpes Zoster; Humans; Male; Middle Aged; Pain; Prognosis

To examine risk factors associated with cerebrovascular accident (CVA) following herpes zoster ophthalmicus (HZO).. Retrospective cohort study.. Review of medical records of all patients with HZO seen at the department of Ophthalmology, Auckland District Health Board, New Zealand, between January 1, 2006, and December 31, 2016. The main outcome measure was cerebrovascular accident within 12 months of diagnosis.. A total of 869 patients diagnosed with HZO were included in the study. The median age at onset of HZO was 65.5 years (interquartile range [IQR] 52.9-75.4), and 52.5% (n=456) were male. Antiviral therapy was started in 765 participants (88.0%), not used in 95 (10.9%), and not documented in 9 participants (1.0%). Four hundred sixty-eight participants (54.9%) received prompt oral antiviral therapy (≤72 hours of rash onset). A CVA occurred in the 12 months following HZO in 14 patients (1.6%) and was most common in older patients, occurring in 2.5% aged ≥65 years, 0.7% aged 40-65 years, and 0.9% aged <40 years. Hazard of CVA was highest immediately following HZO, with median time to CVA of 2.3 months (IQR 0.8-5.9 months). Patients who received prompt acyclovir had a 76.2% lower hazard of CVA (0.9% vs 2.6%, P = .022) on multivariate analysis.. Cerebrovascular accident occurs in a low proportion of individuals within 1 year following HZO. Antiviral treatment for HZO may reduce the risk of subsequent CVA when given within 72 hours of rash onset.

Topics: Acyclovir; Aged; Antiviral Agents; Exanthema; Female; Herpes Zoster Ophthalmicus; Humans; Male; Retrospective Studies; Stroke

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

Topics: Acyclovir; Exanthema; Fever; Humans; Kaposi Varicelliform Eruption

Meningitis retention syndrome (MRS) is a rare condition that presents with acute urinary retention as a complication of aseptic meningitis. Cases of MRS due to varicella zoster virus (VZV) infection without a rash are rare. We report the case of a patient who had no signs of meningitis or VZV infection, including a rash.. A 58-year-old man presented with dysesthesia of the lower limbs and acute urinary retention. He had fever but no rash and no signs of meningitis. He was diagnosed to have VZV infection based on the detection of VZV DNA in the cerebrospinal fluid. He responded satisfactorily to a course of intravenous acyclovir and experienced no sequelae during a 2-year follow-up period.. MRS due to aseptic meningitis of viral origin should be considered in the differential diagnosis of acute urinary retention even in the absence of specific signs and symptoms of meningitis or a suggestive rash.

Topics: Acyclovir; Antiviral Agents; Exanthema; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Meningitis, Aseptic; Middle Aged

Herpes zoster is an infection caused by reactivation of varicella-zoster virus presenting as multiple grouped vesicular eruptions in a dermatomal pattern with associated pain. Recurrent herpes zoster is an uncommon event in an immunocompetent host. Here, we report a case of a young male presenting with herpes zoster over the T9 and T10 dermatome with the previous scarring of herpes zoster over the T6 dermatome over the right upper trunk. The patient improved on treatment with oral acyclovir and analgesics. In any patient with recurrenrt hepes zoster, work-up should be done to rule out immunosuppresion.

Topics: Acyclovir; Exanthema; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Pain

Topics: Acute Kidney Injury; Acyclovir; Aged; Antibodies, Viral; Antiviral Agents; Confusion; Diagnosis, Differential; DNA, Viral; Encephalitis; Encephalitis, Varicella Zoster; Exanthema; Hashimoto Disease; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Magnetic Resonance Imaging; Male; Meningoencephalitis; Neuroimaging; Recurrence

Topics: Acyclovir; Antiviral Agents; Exanthema; Herpes Zoster Ophthalmicus; Humans; Ophthalmoplegia; Orbital Myositis

The aseptic meningitis caused by varicella zoster virus (VZV) reactivation was less described in the literature, most of which were detected by means of polymerase chain reaction. The authors presented 4 adult immunocompetent patients with acute aseptic meningitis with VZV infection diagnosed by next-generation sequencing (NGS).. VZV is an infectious agent that causes aseptic meningitis in immunocompetent adults and could not be accompanied by skin manifestations. The NGS of CSF is a rapid detection for the identification and differentiation of meningitis in patients, which is of great importance for providing the rapid and accurate diagnosis and the targeted antimicrobial therapy for central nervous system infection.

Topics: Acyclovir; Adult; Antiviral Agents; Cerebrospinal Fluid; Exanthema; Herpesvirus 3, Human; High-Throughput Nucleotide Sequencing; Humans; Magnetic Resonance Imaging; Male; Meningitis, Aseptic; Meningitis, Viral; Middle Aged; Varicella Zoster Virus Infection; Young Adult

In 2017, two Thoroughbred stallions, A and B in Farms A and B, respectively, in Hokkaido in Japan showed clinical signs of equine coital exanthema (ECE). In 2020, stallion C in Farm B showed clinical signs of ECE. Eighteen mares were mated within five days before stallion A developed ECE. Ten mares that mated within 3 days before onset showed clinical signs of ECE on the external genitalia. Equine herpesvirus 3 (EHV-3) was isolated from vaginal swabs from three mares that mated within 2 days before onset. Swabs from 12 mares that mated within 4 days before onset were real-time PCR (rPCR)-positive and nine of those mares had an increased EHV-3 antibody titer. The three stallions were administered valaciclovir orally and topical acyclovir ointment was applied. Treatment started on the next day after onset in stallion A and on the day of onset in stallions B and C. EHV-3 was firstly isolated from penis swabs of stallions A and B before treatment and from penis swabs of stallion C 2 days after treatment. EHV-3 was not isolated after 8, 5 and 8 days from onset in stallions A, B and C, respectively. However, swabs were rPCR-positive for at least 12, 9 and 15 days after onset of stallions A, B and C, respectively. EHV-3 was excreted from the stallions at least within 4 days before the onset of ECE, and acyclovir treatment resulted in the termination of excretion within 8 days after onset.

Topics: Acyclovir; Animals; Exanthema; Female; Herpesviridae Infections; Herpesvirus 1, Equid; Herpesvirus 3, Equid; Horse Diseases; Horses; Japan; Male

Topics: Acyclovir; Aged; Antiviral Agents; Breast Neoplasms; Diagnosis, Differential; Exanthema; Facial Dermatoses; Female; Forehead; Herpes Zoster; Humans; Immunocompromised Host; Lung Neoplasms; Neoplasms, Multiple Primary

Topics: Abdominal Pain; Acyclovir; Administration, Intravenous; Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Exanthema; Female; Fever; Herpesvirus 3, Human; HIV Infections; Humans; Immunocompromised Host; Liver; Treatment Outcome; Varicella Zoster Virus Infection

Topics: Acyclovir; Aged; Antineoplastic Agents; Antiviral Agents; Bridged Bicyclo Compounds, Heterocyclic; Exanthema; Female; Hepatitis; Herpesvirus 3, Human; Humans; Immunocompromised Host; Leukemia, Lymphocytic, Chronic, B-Cell; Opportunistic Infections; Pancreatitis; Recurrence; Sulfonamides; Treatment Outcome; Varicella Zoster Virus Infection

Topics: Acyclovir; Adolescent; Antiviral Agents; Exanthema; Female; Humans; Immunocompromised Host; Lip Diseases; Stomatitis, Herpetic

We report a case of fatal disseminated varicella zoster virus (VZV) with delayed-onset rash in a 66-year-old female more than 2 years following uncomplicated deceased donor renal transplantation. Whilst on a stable regimen of maintenance immunosuppression, the patient presented with chest and abdominal pain with concomitant hepatitis and pancreatitis. After pursuing multiple other potential causes of her symptoms, the correct diagnosis of VZV was only suspected after the development of a widespread vesicular rash-11 days after her initial symptoms. Despite antiviral therapy and inotropic support in the intensive care unit, the patient died. Simultaneous VZV hepatitis and pancreatitis in solid organ transplant recipients is uncommon. The new inactivated VZV vaccines have the potential to prevent post-transplant infections, with promising early clinical data on safety and efficacy in renal transplant recipients. VZV is an important preventable infection that should be considered in immunocompromised patients, even in the absence of rash.

Topics: Acyclovir; Aged; Antiviral Agents; Exanthema; Fatal Outcome; Female; Hepatitis; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Kidney Transplantation; Pancreatitis

Herpes zoster (zoster) also commonly known as "shingles," occurs following re-activation of the varicella zoster virus. It contributes a large cost burden to the U.S. health care system, with an estimated 1 million cases costing $1 billion annually. The current gold standard treatment is acyclovir, which limits viral replication. However, acyclovir has been reported to cause neurotoxicity in patients with acute or chronic kidney disease.. This case presents an occurrence of acyclovir-induced toxic encephalopathy in a patient with normal renal function. A 63-year-old male presented to the emergency department with ataxia, tremors, fluctuating aphasia, confusion, agitation, and fatigue. Results of imaging, lumbar puncture, and laboratory studies directed clinicians toward acyclovir toxicity, despite a normal creatinine level. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians will likely be the first point of contact in the health care system following the onset of acyclovir toxicity. With an increasing incidence of zoster disease, such atypical toxic manifestations may increase. Early recognition is important to avoid permanent neurologic compromise.

Topics: Acyclovir; Antiviral Agents; Brain Diseases; Ceftriaxone; Emergency Service, Hospital; Exanthema; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Middle Aged; Neurotoxicity Syndromes

Development of neurological complications of varicella zoster virus reactivation is relatively uncommon, particularly in an immunocompetent child.. An 11-year-old Asian girl presented with headache and skin rash on her left chest. She was diagnosed with meningitis, and herpes zoster was confirmed by polymerase chain reaction using cerebrospinal fluid. Acyclovir was administered intravenously. Given the favorable evolution of the clinical course, she was discharged from the hospital on day 8 of her illness. She had no apparent sequelae or comorbidities at the time of the 6-week follow-up.. Neurological complications such as meningitis due to varicella zoster virus reactivation are uncommon, especially in an immunocompetent child; no specific immune deficiency was identified in our patient. We conclude that, although rare, varicella zoster virus should be recognized as a potential cause of viral meningitis in immunocompetent children.

Topics: Acyclovir; Administration, Intravenous; Antiviral Agents; Cerebrospinal Fluid; Child; Exanthema; Female; Headache; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompetence; Meningitis, Viral; Treatment Outcome

In 2016, the live attenuated zoster vaccine (Zostavax, Merck and Co, USA) was introduced into the Australian National Immunisation Program for people aged 70 years who are not significantly immunocompromised. We report the administration of Zostavax in an immunocompromised patient with chronic lymphocytic leukaemia and no evidence of primary varicella zoster virus (VZV) infection. The patient presented with a bilateral vesicular facial rash 22 days after receiving Zostavax and was initially managed as an outpatient with oral acyclovir. He re-presented three days later and was diagnosed with disseminated VZV infection complicated by meningoencephalitis. The patient died following cardiac arrest on day 10 of hospitalisation. This unfortunate case highlights the challenge of safely implementing a high titre live vaccine in a population where contraindications are prevalent. The non-live recombinant herpes zoster subunit vaccine (Shingrix, GSK) may provide a safe and effective option to protect immunocompromised patients from shingles and post-herpetic neuralgia.

Topics: Acyclovir; Aged; Antiviral Agents; Australia; Contraindications, Procedure; Exanthema; Fatal Outcome; Heart Arrest; Herpes Zoster; Herpes Zoster Vaccine; Hospitalization; Humans; Immunocompromised Host; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Meningoencephalitis; Neuralgia, Postherpetic; Vaccination; Vaccines, Attenuated; Varicella Zoster Virus Infection

Herpes zoster, caused by varicella zoster virus (VZV) reactivation, affects mainly the adult population, although it can occur in children. This happens when primary infection (varicella) has occurred at a very young age or in immunocompromised patients. Complications are rare in healthy individuals. They include VZV cutaneous dissemination, which affects 2%-10% of immunocompromised patients.We present a previously healthy child, with history of varicella during her first month of life, which presented at age 8 with a severe case of herpes zoster, complicated with cutaneous dissemination. Immunity study was unremarkable. Causes, management and follow-up are discussed.

Topics: Acyclovir; Administration, Intravenous; Aftercare; Antiviral Agents; Child; Exanthema; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Skin Diseases; Treatment Outcome

Topics: Acyclovir; Adult; Antiviral Agents; Diagnosis, Differential; Exanthema; Hand Dermatoses; Herpes Simplex; Humans; Male; Skin Diseases, Vesiculobullous; Spider Bites; Thumb; Valacyclovir; Valine

We report a case of varicella-zoster virus (VZV) infection with acute cerebellitis and encephalitis with associated Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in an elderly man presenting with acute cerebellar ataxia without antecedent rash. Cerebrospinal fluid examination (CSF) revealed a mononuclear pleocytosis, high protein, normal glucose, positive for VZV polymerase chain reaction (PCR). Early acyclovir treatment is beneficial for acute VZV cerebellitis. Clinicians should consider infectious Central Nervous System (CNS) causes for presentations of acute cerebellar ataxia in adult patients, particularly if there is an accompanying clouded sensorium.

Topics: Acyclovir; Aged, 80 and over; Antiviral Agents; Cerebellum; Encephalitis, Varicella Zoster; Exanthema; Humans; Inappropriate ADH Syndrome; Male

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

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

Chromosomally integrated human herpesvirus 6 (ciHHV-6) can be transmitted via allogeneic hematopoietic cell transplantation. To date, only a few cases have been reported. Here, we report a case identified as transmission of ciHHV-6 via cord blood transplantation. Distinguishing transmission of ciHHV-6 from HHV-6 reactivation in cases with high titer of HHV-6 DNA load after transplantation is important to prevent unnecessary exposure to antiviral drugs that could be toxic.

Topics: Acyclovir; Antibiotic Prophylaxis; Antiviral Agents; Busulfan; Child, Preschool; Chromosomes, Human, Pair 22; Cord Blood Stem Cell Transplantation; DNA, Viral; Exanthema; Fetal Blood; Fever; Herpesvirus 6, Human; Humans; Immunocompromised Host; Male; Melphalan; Myeloablative Agonists; Roseolovirus Infections; Transplantation Conditioning; Unrelated Donors; Valacyclovir; Valine; Viral Load; Virus Integration

Equine coital exanthema (ECE) has been reported in many countries, but equine herpesvirus 3 (EHV-3) has been isolated only once in Japan. In 2015, symptoms of ECE were found, and EHV-3 was isolated in two stallions. Valacyclovir, an anti-herpesvirus agent, was administered orally. The stallions rested from mating for more than two weeks, causing enormous financial losses because of their high fees. This is the first study in which valacyclovir was administered for ECE. Though valacyclovir treatment did not shorten the duration of healing, the affected area did not expand after administration of valacyclovir. Valacyclovir therefore seems to be effective for suppression of EHV-3 infection. Further investigation about the administration protocol might be required.

Topics: Acyclovir; Animals; Antiviral Agents; Exanthema; Herpesviridae Infections; Herpesvirus 3, Equid; Horse Diseases; Horses; Japan; Male; Sexually Transmitted Diseases, Viral; Valacyclovir; Valine

A 61-year-old man who was an ex-heavy smoker presented to our ambulatory care centre with a 4-week history of dyspnoea on mild exertion. 2 weeks prior to his symptoms, he had developed right-sided cervical herpes zoster for which he was prescribed oral acyclovir by his general practitioner. On examination, a rash over the right C4-5 dermatomes was noted and dullness on percussion of the right mid and lower zones with markedly reduced air entry. His chest radiograph showed a raised right hemi-diaphragm with associated right middle and lower lobe collapse. Further investigation with CT and bronchoscopy did not identify a cause and showed no evidence of underlying malignancy or endobronchial obstruction. An ultrasound 'sniff test' was performed to confirm diaphragmatic paralysis. We present a rare case of cervical herpes-induced diaphragmatic paralysis, and summarise our approach and the current understanding of this interesting condition.

Topics: Acyclovir; Amitriptyline; Diaphragm; Exanthema; Herpes Zoster; Humans; Male; Middle Aged; Neuralgia; Respiratory Paralysis; Treatment Outcome

Topics: Acyclovir; Administration, Oral; Adolescent; Antiviral Agents; CD56 Antigen; Exanthema; Eye Infections, Viral; Herpes Zoster Ophthalmicus; Humans; Immunologic Deficiency Syndromes; Killer Cells, Natural; Male

A bath with scented soap prompted a flare of the boy's eczema. Days later, he was hospitalized with diffuse erosions covering 90% of his body. What was the cause?

Topics: Acyclovir; Anti-Bacterial Agents; Antiviral Agents; Child, Preschool; Eczema; Exanthema; Humans; Kaposi Varicelliform Eruption; Male; Mentha; Perfume; Simplexvirus; Soaps; Steroids; Tacrolimus; Tretoquinol

Topics: Acyclovir; Adolescent; Diagnosis, Differential; Emergency Service, Hospital; Encephalitis, Varicella Zoster; Exanthema; Fever; Headache; Herpesvirus 3, Human; Humans; Infusions, Intravenous; Male; Neck Pain; Risk Assessment; Severity of Illness Index; Treatment Outcome

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

Viral meningitis caused by varicella-zoster virus (VZV) is an uncommon neurological complication of herpes zoster. It may occur before or after the onset of the vesicular rash along the dermatomal distribution, which is the classic presentation of herpes zoster. We describe a case of a 51-year-old immunocompetent Caucasian man who presented with neck and severe right-sided facial pain. Eight days later, he had photophobia and papular rash on his forehead. Cerebrospinal fluid (CSF) examination confirmed aseptic meningitis and CSF PCR detected the presence of VZV DNA. Neurological complications of VZV infection, such as aseptic meningitis, may be difficult to diagnose and can cause delay in treatment, especially in cases with late onset of dermatological manifestations of herpes zoster. Definite diagnosis requires evidence of acute VZV infection in blood or cerebrospinal fluid.

Topics: Acyclovir; Antiviral Agents; Diagnosis, Differential; Exanthema; Herpes Zoster; Humans; Male; Meningitis, Viral; Middle Aged; Polymerase Chain Reaction; Valacyclovir; Valine

To present a case of Herpes Zoster Ophtalmicus (HZO), which was reactivated postoperatively after a sinus lift operation.. A 39-year-old male was referred to our clinic for implant-supported dental rehabilitation. He had maxillary missing teeth in positions 13, 14, 15 and 16 and a pneumatised right maxillary sinus with a bone height of 2 mm. Lateral sinus lifting and bone block grafting was performed before implant insertion. Twelve days after the sinus lift, the patient complained of pain and itching at the infraorbital area extending to the forehead. Clinical examination revealed no signs of infection or allergy. The patient received consultation from a dermatologist in order to rule out a possible dermatological disorder. Finally he was diagnosed with HZO.. HZO was managed with systemic acyclovir treatment. Vesicular rashes and ptosis was seen 3 days after the medical treatment. After 1 month no postoperative skin or orbital sequela was seen. Three implants were inserted at the right posterior maxilla 5 months after sinus lift. One-year followup was uneventful.. Dermatological diseases should always be kept in mind during the differential diagnosis of orofacial pain. In this case the proximity of the operation site and affected area gave rise to the idea that surgical trauma had a possible role in the reactivation of the virus. However, the process of reactivation is not entirely understood and requires further investigations. Early diagnosis is essential for HZO in order to avoid debilitating complications such as postherpetic neuralgia and blindness.

Topics: Acyclovir; Adult; Antiviral Agents; Autografts; Blepharoptosis; Bone Transplantation; Dental Implantation, Endosseous; Exanthema; Follow-Up Studies; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Male; Pain, Postoperative; Pruritus; Sinus Floor Augmentation; Virus Activation

Eczema herpeticum is an easily missed entity most commonly seen in the pediatric population and carries the risk of systemic compromise and a 10% mortality rate. Clinicians should maintain high clinical suspicion when encountering children or young adults with a history of atopic dermatitis or other erosive dermatoses and who present with vesicular lesions, punched-out erosions, and systemic symptoms. We present 3 severe cases of eczema herpeticum that were potentially overlooked and demonstrate the need for elevated awareness to avoid potential pitfalls.

Topics: Acyclovir; Adolescent; Antiviral Agents; Child, Preschool; Exanthema; Female; Humans; Infant; Kaposi Varicelliform Eruption; Male

Ramsay Hunt Syndrome (RHS) is the result of herpes zoster virus reactivation producing hearing loss, pain and vesicles in the ear or mouth, along with ipsilateral facial palsy due to the 7th cranial nerve geniculate ganglion infectious involvement. This condition has not been previously described, particularly in transplant patients. A 38-year old man underwent kidney transplantation and two years later experienced an ache on the left side of the face and hearing loss in the ear, also exhibiting vesicular lesions and concomitant facial peripheral palsy. Acyclovir IV was initiated, and the prednisone dose was increased. The patient was discharged 15 days later, feeling better but still exhibiting dark spots on his face. At three months follow-up he was asymptomatic, showing notable palsy improvement. Until this case, herpes zoster facial lesions causing typical RHS have never been reported in literature, particularly in kidney transplant patients.

Topics: Acyclovir; Adult; Antiviral Agents; Exanthema; Face; Facial Paralysis; Herpes Zoster Oticus; Humans; Kidney Transplantation; Male

Topics: Acyclovir; Child; Exanthema; Female; Herpes Zoster; Humans; Pain

Topics: Acyclovir; Aged; Anti-Inflammatory Agents; Antiviral Agents; Earache; Exanthema; Facial Dermatoses; Facial Paralysis; Herpes Zoster Oticus; Humans; Male; Prednisolone; Treatment Outcome

We describe a patient with zoster paresis and an MRI that revealed extensive spinal cord lesions from the upper cervical to the lower thoracic spinal cord. Importantly, the patient reported considerable spontaneous improvement in strength 2-3 weeks after zoster. This report reveals a previously undescribed remarkable preponderance of MRI lesions far beyond the site of zoster rash and focal lower motor neuron weakness.

Topics: Acyclovir; Aged; Antiviral Agents; Exanthema; Female; Herpes Zoster; Humans; Magnetic Resonance Imaging; Motor Neuron Disease; Muscle Weakness; Spinal Cord; Spinal Nerve Roots; Valacyclovir; Valine

Topics: Acyclovir; Adult; Antiviral Agents; Back Pain; Exanthema; Face; Female; Hepatitis; Herpes Simplex; Herpesvirus 2, Human; Humans; Lumbosacral Region; Magnetic Resonance Imaging; Neck; Serositis

Topics: Acyclovir; Anti-Bacterial Agents; Antiviral Agents; Exanthema; Facial Dermatoses; Floxacillin; Gingival Diseases; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Maxillary Diseases; Middle Aged; Mouth Mucosa; Osteonecrosis; Penicillin G; Virus Activation

Topics: Abdominal Pain; Acyclovir; Aged; Antiviral Agents; Exanthema; Hepatitis; Herpes Genitalis; Herpesvirus 2, Human; Humans; Male; Pancreatitis; Skin Diseases, Vesiculobullous; Treatment Outcome

Varicella zoster virus (VZV) is a leading cause of acute viral encephalitis but little is known about its clinical, biological and imaging features. Furthermore, the most favourable treatment regimen has not been determined. We studied a prospective cohort of 20 HIV-negative patients presenting with acute VZV encephalitis caused by primary infection or reactivation. VZV was identified in 16 of 20 cases by PCR detection of the DNA in the cerebrospinal fluid. The four remaining cases occurred during or soon after a VZV rash. The median age of the 17 adults was 76 (19-86) years; the three other patients were children (0.5-5 years). Three patients were immunocompromised. Nine adult patients presented with a rash. Eighteen patients presented with fever and an acute encephalitic syndrome: diffuse brain dysfunction, focal neurological signs, seizures and cranial nerve palsies. Three patients presented with either ventricular or subdural haemorrhage, one with myelitis, and one with asymptomatic stenosis of the middle cerebral artery. The imaging was either normal or revealed non-specific abnormalities such as cortical atrophy but no evidence of stroke. All patients were given acyclovir at various dosages and durations but the case fatality rate remained high (15%) and sequelae were frequently observed either at discharge or at follow-up 3 years later.

Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Antiviral Agents; Brain; Cerebrospinal Fluid; Child, Preschool; Cohort Studies; DNA, Viral; Encephalitis, Varicella Zoster; Exanthema; Female; Herpesvirus 3, Human; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Middle Aged; Polymerase Chain Reaction; Prospective Studies; Radiography; Survival Analysis; Treatment Outcome

This study was performed during an era of partial vaccination with varicella vaccine in Israel to characterize ambulatory pediatric herpes zoster (HZ) cases in a population with partial varicella vaccination coverage.. Data were collected from computerized databases of a population of 114,000 children. Records of children aged 0-18 years, diagnosed with HZ during 2006 to 2008 were reviewed by pediatric infectious diseases experts. Telephone interviews were done with a sample of the parents to get further clinical details.. Of 692 medical records reviewed, 450 cases were approved for analysis, and 77 interviews were conducted. Incidence of HZ was 130 of 100,000 person life-years. Peak incidence was detected in children aged 9-11 years (222/100,000 person life-years). Pain and fever accompanied 52% and 13% of episodes, respectively. Higher risk for HZ was found in children who had varicella during their first year of life (relative risk and 95% confidence interval: 13.5[9.6-18.8]; P < 0.001), and in children who had varicella during the second year of life (relative risk = 2 [1.5-2.6]; P < 0.001). Vaccination was found to be protective against HZ (relative risk = 0.42 [0.33-0.55]; P < 0.001).. The epidemiology of HZ seems to be changing in a population with partial varicella vaccination rate. Our results may suggest that children who contracted chicken pox in their first year of life may benefit from varicella vaccination.

Topics: Acyclovir; Adolescent; Antiviral Agents; Chi-Square Distribution; Chickenpox Vaccine; Child; Child, Preschool; Exanthema; Female; Herpes Zoster; Humans; Incidence; Infant; Interviews as Topic; Israel; Male; Retrospective Studies; Vaccination

A male university student, 24 years of age, presented to his general practitioner because of a facial rash. He had a past history of eczema but no other significant past medical history and no allergies. He was not taking any regular medications.

Topics: Acyclovir; Antiviral Agents; Diagnosis, Differential; Exanthema; Facial Dermatoses; Humans; Kaposi Varicelliform Eruption; Male; Valacyclovir; Valine; Young Adult

Topics: Acyclovir; Aged; Antiviral Agents; Exanthema; Female; Herpes Zoster; Herpes Zoster Vaccine; Humans; Male; Neuralgia, Postherpetic; Risk Factors; Spouses; Valacyclovir; Valine

Herpes simplex virus (HSV) is an unusual cause of postpartum endometritis. We describe a rare case of primary disseminated maternal HSV in the postpartum period associated with endometritis.. A previously healthy patient developed fundal tenderness and postpartum fevers after an uncomplicated vaginal delivery. Despite traditional broad-spectrum antimicrobial therapy, she had persistent fevers and systemic symptoms. Concurrently, her neonate developed fevers and a nonvesicular rash, with viral cultures ultimately returning positive for HSV. The patient developed active pharyngeal and genital herpetic lesions and was diagnosed with HSV endometritis and disseminated HSV. Symptoms and fevers in both the mother and neonate responded to antiviral therapy.. Herpes simplex virus endometritis should be included in the differential diagnosis for postpartum fevers and fundal tenderness that are unresponsive to broad-spectrum antimicrobial treatment.

Topics: Acyclovir; Adult; Antiviral Agents; Endometritis; Exanthema; Female; Fever; Herpes Simplex; Herpesvirus 2, Human; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Postpartum Period; Pregnancy; Pregnancy Complications, Infectious; Tomography, X-Ray Computed

Topics: Acyclovir; Anti-Bacterial Agents; Antiviral Agents; Diagnosis, Differential; Drug Therapy, Combination; Exanthema; Female; Herpes Simplex; Herpesvirus 1, Human; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infectious Disease Transmission, Vertical; Mouth Mucosa; Skin Diseases, Vesiculobullous

Viral infection is a rare cause of painful ophthalmoplegia. We report on a 67-year-old patient who developed painful double vision after a vesicular skin rash on the left forehead. MRI disclosed simultaneous inflammatory lesions in all extraocular muscles, the second and third cranial nerve, as well as pathological signal intensity along the spinal trigeminal tract and nucleus within the medulla oblongata and the pons. Cerebrospinal fluid and serum tests for varicella zoster were positive. The patient was treated effectively with intravenous acyclovir and methylprednisolone. Simultaneous lesions in various neighbouring neural structures may be characteristic for the highly neurotropic behaviour of the herpesviridae and should be considered as a cause of painful ophthalmoplegia that can be depicted by appropriate imaging.

Topics: Acyclovir; Aged; Anti-Inflammatory Agents; Antiviral Agents; Diplopia; Exanthema; Female; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Methylprednisolone; Oculomotor Nerve; Oculomotor Nerve Diseases; Optic Nerve; Optic Nerve Diseases; Orbit; Orbital Myositis; Tolosa-Hunt Syndrome; Trigeminal Nuclei

Topics: Acyclovir; Adult; Antiviral Agents; Biopsy; Dermatitis, Atopic; Diagnosis, Differential; Exanthema; Facial Dermatoses; Herpesvirus 1, Human; Humans; Kaposi Varicelliform Eruption; Male; Skin; Social Stigma

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

The herpes zoster virus is a rare but potential cause of acute motor weakness. This article describes 2 patients with drop foot secondary to an infection of varicella zoster who were incorrectly referred to an orthopedic clinic from their general practitioners. The first patient was a 74-year-old man who presented with weakness in the right foot and a vesicular rash. The pattern of disease supported the clinical diagnosis of shingles affecting the L5 motor and sensory division. No investigation was required, and the patient was treated with a foot drop splint. The second patient was a 71-year-old man who presented with right leg and foot weakness and a vesicular rash affecting his right buttock and posterior right thigh. Lumbar magnetic resonance excluded a stenotic lesion; electrophysiological studies supported the diagnosis of a lower motor neuron lesion. The patient was treated with a 1-week course of acyclovir and a foot drop splint. The correct diagnosis will aid in correct referral and will prompt management, which will potentially provide a faster and better outcome for the patient.

Topics: Acyclovir; Aged; Antiviral Agents; Electrophysiology; Exanthema; Gait Disorders, Neurologic; Herpes Zoster; Herpesvirus 3, Human; Humans; Magnetic Resonance Imaging; Male; Muscle Weakness; Sciatica; Splints; Treatment Outcome

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

Topics: Acyclovir; Adult; Antiviral Agents; Exanthema; Herpesvirus 3, Human; Humans; Male; Pneumonia; Radiography

Topics: Acyclovir; Antiviral Agents; Child; Drug Therapy, Combination; Exanthema; Facial Paralysis; Glucocorticoids; Herpes Zoster Oticus; Herpesvirus 3, Human; Humans; Male; Prednisone; Tongue; Tongue Diseases; Ulcer

Topics: Acyclovir; Antineoplastic Agents; Antiviral Agents; Bromodeoxyuridine; Diagnosis, Differential; Esophageal Neoplasms; Exanthema; Herpes Zoster; Humans; Leg; Lymphoma, Mantle-Cell; Male; Middle Aged; Paraneoplastic Syndromes; Vasculitis, Leukocytoclastic, Cutaneous

Topics: Acyclovir; Aged; Antiviral Agents; Edema; Erythema; Exanthema; Face; Female; Folliculitis; Herpesviridae Infections; Humans; Treatment Outcome

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

Drug-related eruptions that appear only on intertriginous or flexural folds and in gluteal areas have recently been termed symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). We report a case of a 56-year-old woman with acute erythematous rash in the intertriginous areas after treatment with the L-valine ester of acyclovir, valacyclovir. Oral-challenge tests resulted in erythematous pruritic rash in the intertriginous area by valacyclovir. The patient was diagnosed as having SDRIFE due to valacyclovir.

Topics: Acyclovir; Antiviral Agents; Axilla; Drug Eruptions; Exanthema; Female; Herpes Zoster; Humans; Middle Aged; Neck; Valacyclovir; Valine

We report varicella-zoster virus (VZV) meningitis in a healthy adult woman with no antecedent rash and with hypoglycorrhachia. Cerebrospinal fluid (CSF) examination revealed the presence of VZV DNA, anti-VZV immunoglobulin G (IgG) antibody, and intrathecal production of anti-VZV IgG antibody.

Topics: Acyclovir; Adult; Antiviral Agents; DNA, Viral; Exanthema; Female; Glucose; Headache; Herpesvirus 3, Human; Humans; Immunocompetence; Meningitis, Viral

Topics: Acyclovir; Adolescent; Anti-Inflammatory Agents; Antiviral Agents; Biopsy; Diagnosis, Differential; Exanthema; Fatal Outcome; Fever; Humans; India; Lymphadenitis; Lymphomatoid Papulosis; Male; Neck; Pityriasis Lichenoides; Skin Ulcer

Brachial plexus neuritis in the presence of herpes zoster infection is uncommon. Motor involvement is probably due to the spreading of inflammation from the dorsal root ganglia to the ventral roots and may be more extensive than the affected dermatomes. We present a case of herpes zoster brachial plexopathy with pure motor involvement both clinically and electrophysiologically.

Topics: Acyclovir; Aged; Antibodies, Viral; Antiviral Agents; Arm; Axons; Brachial Plexus Neuropathies; Electrodiagnosis; Electromyography; Exanthema; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Motor Neuron Disease; Motor Neurons; Muscle Weakness; Muscle, Skeletal; Muscular Atrophy; Neural Conduction; Spinal Nerve Roots; Treatment Failure; Wallerian Degeneration

To assess the etiology, prognosis, and appropriate treatment of hemophagocytic lymphohistiocytosis (HLH) in neonates.. We collected information on neonates in whom HLH was diagnosed between 1997 and 2007 from participating members of the Japanese Society of Pediatric Hematology.. HLH was diagnosed in 20 patients within 4 weeks after birth. Of the diagnostic criteria for HLH-2004, the incidence of fever was quite low in preterm infants, and hypertriglyceridemia and neutropenia were uncommon. Familial HLH (n = 6) or severe combined immunodeficiency-associated HLH (n = 1) was diagnosed in 7 patients, and 2 of them have survived. Herpes simplex virus-associated HLH was diagnosed in 6 patients, and 2 of them have survived. The overall survival rate for the 20 patients was 40%.. HLH is rare in neonates and has a poor prognosis. Early diagnosis and immediate treatment are required when considering the possibility of herpes simplex virus-associated or familial HLH.

Topics: Acyclovir; Adrenal Cortex Hormones; Antineoplastic Agents, Phytogenic; Antiviral Agents; beta 2-Microglobulin; Consciousness Disorders; Cyclosporine; Erythema; Etoposide; Exanthema; Female; Fetal Distress; Fever; gamma-Globulins; Hematopoietic Stem Cell Transplantation; Herpes Simplex; Humans; Immunologic Factors; Immunosuppressive Agents; Infant, Newborn; Infant, Premature; Japan; L-Lactate Dehydrogenase; Leukocytosis; Lymphohistiocytosis, Hemophagocytic; Male; Ocular Motility Disorders; Plasma Exchange; Prognosis; Respiratory Distress Syndrome, Newborn; Seizures; Severe Combined Immunodeficiency

Topics: Acyclovir; Aged; Antiviral Agents; Confusion; Encephalitis, Varicella Zoster; Exanthema; Fever of Unknown Origin; Humans; Male

Topics: Acyclovir; Anti-Inflammatory Agents; Antineoplastic Agents; Antiviral Agents; Boronic Acids; Bortezomib; Dexamethasone; Exanthema; Herpes Zoster; Humans; Male; Middle Aged; Multiple Myeloma; Pyrazines; Skin; Treatment Outcome

Segmental zoster paresis is a relatively rare complication characterized by focal motor weakness, which may occur in limbs affected by herpes zoster. We demonstrate the clinical characteristics of segmental zoster paresis by reviewing the cases of 138 patients, including 3 of our patients.. We report 3 patients with zoster paresis of the limbs. Patients 1 and 3 showed motor weakness in the left shoulder and arm after developing a herpetic rash in the left C5-C6 dermatomes. Patient 2 showed weakness in the right thigh and groin after a right L2-L3 herpetic eruption. The electromyograms of all 3 patients showed abnormal spontaneous activity in the affected muscles. Intravenous acyclovir and corticosteroid pulse therapy were added to oral antiviral drugs for patients 1 and 2. All 3 patients recovered favorably. Our review of the literature revealed that antiviral treatment may prevent the occurrence of zoster paresis; however, there is insufficient evidence to show what treatment hastens recovery from zoster paresis.. Segmental zoster paresis is still underrecognized by neurologists. Awareness of this disorder is important because it may eliminate unnecessary invasive investigations and lead to appropriate treatment. Further studies on the treatment are necessary.

Topics: Acyclovir; Aged; Antiviral Agents; Diabetes Complications; Electromyography; Exanthema; Female; Herpes Zoster; Humans; Lower Extremity; Magnetic Resonance Imaging; Male; Middle Aged; Muscle Weakness; Neural Conduction; Paralysis; Risk Factors; Skin; Upper Extremity

Topics: Acyclovir; Anti-Bacterial Agents; Anticonvulsants; Antiviral Agents; Exanthema; Female; Humans; Kaposi Varicelliform Eruption; Middle Aged; Phenytoin

Topics: Acyclovir; Adult; Antiviral Agents; Drug Hypersensitivity; Eczema; Exanthema; Eye Diseases; Eyelids; Face; Humans; Kaposi Varicelliform Eruption; Male; Penicillins; Staphylococcal Infections

Postherpetic neuralgia (PHN) is dermatomal distribution pain that persists for months to years after the resolution of herpes zoster rash. The cause of PHN is unknown. Herein, we report clinical, molecular virological, and immunological findings over an 11-year period in an immunocompetent elderly woman with PHN. Initially, blood mononuclear cells (MNCs) contained varicella-zoster virus (VZV) DNA on two consecutive occasions. Random testing after treatment with famciclovir to relieve pain did not detect VZV DNA. However, the patient was reluctant to continue famciclovir indefinitely and voluntarily stopped drug treatment five times. Pain always recurred within 1 week, and blood MNCs contained many, but not all, regions of the VZV genome on all five occasions. Immunological analysis revealed increased cell-mediated immunity to VZV. Chronic VZV ganglionitis-induced PHN best explains the recurrence of VZV DNA in MNCs whenever famciclovir was discontinued; the detection of only some regions of the viral genome in MNCs, compared to the detection of all regions of the VZV genome in latently infected ganglia; the increased cell-mediated immunity to VZV; and a gratifying clinical response to famciclovir. The presence of fragments of VZV DNA in MNCs likely represents partial degradation of viral DNA in MNCs that trafficked through ganglia during productive infection.

Topics: 2-Aminopurine; Acyclovir; Amitriptyline; Analgesics, Non-Narcotic; Antibodies, Viral; Antiviral Agents; Chronic Disease; DNA, Viral; Dysgeusia; Exanthema; Facial Neuralgia; Facial Paralysis; Famciclovir; Female; Follow-Up Studies; Herpes Zoster Oticus; Herpesvirus 3, Human; Humans; Hyperacusis; Immunoglobulin G; Leukocytes, Mononuclear; Middle Aged; Scalp

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

Topics: Acyclovir; Digestive System; Exanthema; Headache; Herpes Labialis; Humans; Randomized Controlled Trials as Topic; Valacyclovir; Valine

Topics: Acyclovir; Adult; Antibodies, Viral; Antiviral Agents; Epstein-Barr Virus Infections; Exanthema; Herpesvirus 4, Human; Humans; Male; Pityriasis

Topics: Acyclovir; Antifungal Agents; Antiviral Agents; Exanthema; Forehead; Humans; Infant, Newborn; Male; Nystatin

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

Inoculation of congenitally hairless guinea pigs with varicella-zoster virus (VZV) (Oka strain) results in a self-limited exanthematous infection analogous to varicella in children. Administration of acyclovir or 6-methoxypurine arabinoside modified the course of infection. This model should facilitate pre-clinical testing of putative anti-VZV agents.

Topics: Acyclovir; Animals; Antiviral Agents; Cells, Cultured; Child, Preschool; Disease Models, Animal; Drug Evaluation, Preclinical; Exanthema; Guinea Pigs; Herpes Zoster; Herpesvirus 3, Human; Humans