acyclovir and Hematoma

Acyclovir has been widely used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus (VZV). The common adverse effects of this drug include nausea, diarrhea, headache, dizziness and mental changes. The immune thrombocytopenia induced by acyclovir is rare.. A 67-year-old Chinese male who was given acyclovir 5 mg kg. There have been few reports of acyclovir-induced immune thrombocytopenia. This is the first case report and literature review of acyclovir-induced immune thrombocytopenia, with tongue hematoma as the first sign. Dentists should never overlook this rare adverse effect of acyclovir, as a rapid and appropriate treatment may prevent further severe life-threatening complications.

Topics: Acyclovir; Aged; Antiviral Agents; Hematoma; Humans; Infusions, Intravenous; Male; Platelet Count; Purpura, Thrombocytopenic, Idiopathic; Tongue

This is a case report of PCR proven herpes simplex (HSV-1) encephalitis in a 26 years old immunocompetent adult taking an unusual course of acute intracerebral haematoma after successful and complete recovery with acyclovir therapy. This transient late complication was associated with a negative repeat CSF PCR for HSV suggesting that the initial 14 days course of acyclovir was successful in the eradication of the herpes virus infection as recommended by the International Herpes Management Forum (IHMF). The location of the haematoma corresponded to the initial encephalitic area involving the medial temporal lobe structures. Despite this late neuroradiologic complication, after day 18 of symptom onset, the patient had a favourable neurological outcome. To the best of our knowledge, this is the second report of the unusual, rare, and late neuroimaging complication of acute intracerebral haematoma formation after complete recovery from treated HSVE with favourable clinical outcome. The literature is reviewed and plausible aetiology is discussed.

Topics: Acyclovir; Adult; Antiviral Agents; Cerebral Hemorrhage; Encephalitis, Herpes Simplex; Hematoma; Humans; Male; Temporal Lobe

Topics: Acyclovir; Antiviral Agents; Bacteremia; Catalase; Catheterization; Cellulitis; Contusions; Female; Floxacillin; Hematoma; Herpes Labialis; Humans; Middle Aged; Myelodysplastic Syndromes; Penicillins; Staphylococcal Infections; Staphylococcus aureus

To describe two patients who developed an intracranial hematoma as a complication of temporal lobe encephalitis due to herpes simplex type 1 virus, and to review the literature.. The first patient, a 45-year-old woman developed a brain hematoma in the location of the encephalitic lesion on day 9 after the onset of herpes simplex encephalitis (HSE) that required surgical evacuation. The second patient, a 53-year-old woman was being treated for HSE; on day 8 after admission a temporal lobe hematoma with midline shift was disclosed due to persistent headache. Both patients survived but were left with sequelae. We conducted a PubMed/MEDLINE search from 1986 to April 2013 on this topic.. We have found 20 additional cases reported in the literature and review their characteristics. Hemorrhage was present on admission in 35% of pooled patients, and consistently involved the area of encephalitis. Clinical presentation of intracranial hemorrhage overlapped the encephalitic symptoms in two-thirds of the patients. Half of patients underwent surgery. Overall, mortality rate was low (5.2%), and half of patients fully recovered.. Intracranial bleeding, although infrequent, can complicate the evolution of herpes simplex encephalitis and should be borne in mind since its presence may require neurosurgery. Although its presentation may overlap the encephalitic features, the lack of improvement or the worsening of initial symptoms, particularly during the second week of admission, should lead to this suspicion and to perform a neuroimaging study.

Topics: Acyclovir; Antiviral Agents; Brain; Cerebral Hemorrhage; Decompressive Craniectomy; Encephalitis, Herpes Simplex; Female; Glasgow Coma Scale; Hematoma; Hepatitis C; Humans; Magnetic Resonance Imaging; Middle Aged; Nervous System Diseases; Neurosurgical Procedures; Tomography, X-Ray Computed; Treatment Outcome

Topics: Acyclovir; Adult; Brain Edema; Cerebral Hemorrhage; Craniotomy; Emergencies; Encephalitis, Herpes Simplex; Fatal Outcome; Female; Hematoma; Hemiplegia; Humans; Magnetic Resonance Imaging; Mydriasis; Respiratory Insufficiency; Temporal Lobe; Tomography, X-Ray Computed

We report a case of a 35-year-old female with herpetic meningoencephalitis confirmed by polymerase chain reaction and immunohistochemical study for herpes simplex virus-1 accompanied with a massive intracerebral hematoma as a complication. A hematoma localized at the medial temporal lobe and the medial frontal lobe occurred on the 11th day after initiation of acyclovir treatment. She subsequently required emergency surgery for temporal lobectomy, as well as hematoma and external decompression. Intracerebral hematoma with MR imaging showed gyral pattern along the cortex of the medial temporal lobe and the base of the medial frontal lobe. We speculate that the hemorrhage occurred by rupture of small vessels affected by vasculitis in addition to hypertension caused by increased intracranial pressure. We therefore emphasize the risk of intracerebral hemorrhage at an early stage or during acyclovir treatment, especially during one or two weeks after initiation of the treatment, and the necessity of careful observation during these periods.

Topics: Acyclovir; Adult; Antiviral Agents; Cerebral Hemorrhage; Encephalitis, Herpes Simplex; Female; Frontal Lobe; Hematoma; Humans; Temporal Lobe