acyclovir and Lymphangitis

Lymphangitis and lymphedema are rarely reported complications of herpetic hand or genital infection. The natural history of these complications is gradual resolution over 14 to 21 days. Recognition of this presentation of herpes infection avoids unnecessary surgery and antibacterial therapy. Antiviral therapy may have a role in shortening the duration of symptoms and aborting recurrent lymphangitic episodes.

Topics: Acyclovir; Administration, Oral; Adult; Female; Fingers; Hand Dermatoses; Herpes Simplex; Humans; Lymphangitis; Male; Middle Aged; Recurrence

Topics: Acyclovir; Antiviral Agents; Female; Fingers; Gingivitis; Herpes Simplex; Herpesvirus 1, Human; Humans; Infant; Lymphangitis; Stomatitis, Herpetic

Upper limb lymphangitis often complicates varied wounds on the hand or forearm and improvement is obtained in a few days with adapted antibiotic therapy. A 28-year-old woman presented since few years episodes of lymphangitis of the arm associated with vesicles on an erythematous base, on the palmar face of the first phalanx of the index finger, spontaneous relief within 10 days, without antibiotic therapy. Herpetic origin was confirmed on viral culture. No primary infection neither recurrence was noted. Because of the recurrences, a prophylactic treatment with valaciclovir was instituted. There was no reported recurrence at two years follow-up. Upper limb lymphangitis rarely complicates herpetic whitlow in immunocompetent patient. Clinicians should be aware of viral lymphangitis, which is often overlooked and associated with diagnostic errors and treatment delay.

Topics: Acyclovir; Adult; Antiviral Agents; Female; Herpes Simplex; Humans; Lymphangitis; Prodrugs; Recurrence; Simplexvirus; Upper Extremity; Valacyclovir; Valine