acyclovir and Remission--Spontaneous

(1) To describe the demographic features of patients with voiding dysfunction associated with herpes zoster; (2) to discuss the pathophysiology of voiding dysfunction associated with herpes zoster; and (3) to suggest the best management policy.. A retrospective study.. A university-affiliated medical center in Taiwan.. Four hundred twenty-three patients (mean age, 55.5y) admitted with the diagnosis of herpes zoster from 1988 to 2000.. Not applicable.. Dermatomal distribution of skin eruptions, urologic symptoms, treatment (catheterization, urecholine), clinical course of voiding dysfunction, and outcome.. Seventeen (mean age, 61.2+/-14.1y) of 423 patients (4.02%) with voiding dysfunction related to this virus infection were identified. Ten (58.8%) were men, and 7 (41.2%) were women. The incidence of dysfunction was as high as 28.6% if only lumbosacral dermatome-involved patients were considered. We classified urologic manifestations caused by herpes zoster into 3 groups: cystitis-associated (n=12), neuritis-associated (n=4), and myelitis-associated (n=1). Urinalysis revealed pyuria in all patients with cystitis-associated voiding dysfunction and microscopic hematuria in all patients with neuritis-associated voiding dysfunction. All patients, although receiving different treatment regimens for voiding dysfunction, regained a normal or balanced bladder within 8 weeks. No major urologic sequelae were noted.. Voiding dysfunction, although a transient course, is not uncommon in patients with herpes zoster involving lumbosacral dermatomes. Treatment with intermittent catheterization (our preferred choice) or indwelling catheter placement is recommended if the patients have prolonged difficulty in urination. This disease entity usually has a benign clinical course, and almost every patient will either regain normal voiding or, at least, balanced bladder function.

Topics: Academic Medical Centers; Acyclovir; Adult; Aged; Antiviral Agents; Bethanechol; Cystitis; Diagnosis, Differential; Electrodiagnosis; Female; Herpes Zoster; Humans; Lumbosacral Region; Male; Middle Aged; Parasympathomimetics; Remission, Spontaneous; Retrospective Studies; Risk Factors; Taiwan; Urinalysis; Urinary Bladder, Neurogenic; Urinary Catheterization; Urodynamics

Twenty-six cases of B cell lymphoproliferative disorder (BLPD) were identified among 2395 patients following hematopoietic stem cell transplants (HSCT) for which an overall incidence of BLPD was 1.2%. The true incidence was probably higher, since 9/26 of the diagnoses were made at autopsy. No BLPD was observed following autologous HSCT, so risk factor analyses were confined to the 1542 allogeneic HSCT. Factors assessed were HLA-mismatching (> or = 1 antigen), T cell depletion (TCD), presence of acute GvHD (grades II-IV), donor type (related vs unrelated), age of recipient and donor, and underlying disease. Factors found to be statistically significant included patients transplanted for immune deficiency and CML, donor age > or = 18 years, TCD, and HLA-mismatching, with recipients of combined TCD and HLA-mismatched grafts having the highest incidence. Factors found to be statistically significant in a multiple regression analysis were TCD, donor age and immune deficiency, although 7/8 of the patients with immunodeficiencies and BLPD received a TCD graft from a haploidentical parent. The overall mortality was 92% (24/26). One patient had a spontaneous remission, but subsequently died >1 year later of chronic GVHD. Thirteen patients received therapy for BLPD. Three patients received lymphocyte infusions without response. The only patients with responses and longterm survival received alpha interferon (alphaIFN). Of seven patients treated with alphaIFN there were four responses (one partial and three complete). These data demonstrate that alphaIFN can be an effective agent against BLPD following HSCT, if a timely diagnosis is made.

Topics: Acyclovir; Adjuvants, Immunologic; Adolescent; Adult; Antiviral Agents; B-Lymphocytes; Blood Donors; Child; Epstein-Barr Virus Infections; Female; Genetic Diseases, Inborn; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Herpesvirus 4, Human; Histocompatibility; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Immunophenotyping; Immunosuppression Therapy; Incidence; Infant; Interferon-alpha; Leukemia; Life Tables; Lymphoproliferative Disorders; Male; Middle Aged; Nuclear Family; Parents; Remission, Spontaneous; Retrospective Studies; Risk Factors; Severe Combined Immunodeficiency; T-Lymphocytes, Cytotoxic; Transplantation, Homologous; Treatment Outcome

A 2.5-year-old boy presented to his pediatrician with progressive pallor, asthenia, fever, splenomegaly, and hematomas. Leukemia was suspected, and a bone marrow aspirate confirmed acute lymphoblastic leukemia. Before chemotherapy induction, the child developed a vesicular rash and was diagnosed clinically with chickenpox. Acyclovir treatment was initiated immediately, whereas induction chemotherapy was postponed by 10 days. At the time of chickenpox resolution, a spontaneous partial recovery of his blood counts and a 50% decrease of blastic bone marrow infiltration were noted. After a brief nonsystematic review, we discuss the potential beneficial effect of acyclovir and chickenpox infection in children with leukemia.

Topics: Acyclovir; Antiviral Agents; Chickenpox; Child, Preschool; Herpesvirus 3, Human; Humans; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission, Spontaneous

Topics: Acyclovir; Antibodies, Viral; Antigens, Viral; Antiviral Agents; Capsid Proteins; DNA, Viral; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Histamine Antagonists; Humans; Prednisone; Remission, Spontaneous; Urticaria; Virus Activation; Young Adult

Topics: Acyclovir; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Child; Female; Hair Diseases; Humans; Immunosuppressive Agents; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission, Spontaneous; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acyclovir; Aged; Antiviral Agents; Biopsy; Dermis; Diagnosis, Differential; Female; Follow-Up Studies; Granuloma Annulare; Hand Dermatoses; Herpes Zoster; Humans; Injections, Intravenous; Remission, Spontaneous; Scalp Dermatoses; Thoracic Wall

Congenital Langerhans cell histiocytosis (LCH) is a rare condition with great diversity. A case of congenital skin-only LCH presenting as a "blueberry muffin baby" with a spontaneous regression by the age of 8 months is reported here. New insights into clinical manifestations and prognosis, which is not uniformly positive, are discussed. A thorough examination and a careful follow-up should be provided to these patients. Systemic therapy is warranted in multi-system disease; no consensus on treatment exists in case of LCH isolated to skin. The diagnosis of congenital self-healing LCH should be made only retrospectively.

Topics: Acyclovir; Follow-Up Studies; Histiocytosis, Langerhans-Cell; Humans; Infant; Injections, Intravenous; Male; Penicillin G; Predictive Value of Tests; Prognosis; Rare Diseases; Remission, Spontaneous; Skin Diseases; Tobramycin

Topics: Acyclovir; Chickenpox; Child; Humans; Ichthyosis; Male; Remission, Spontaneous; Skin

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Cytomegalovirus Infections; Ganciclovir; Humans; Male; Remission, Spontaneous; Retinitis