acyclovir and Urinary-Tract-Infections

The introduction of new protocols of immune suppression and especially the use of cyclosporine have led to a marked reduction of infective pathology in children receiving transplants. Nevertheless, infections still represent a major factor of morbidity and mortality in these patients. The above study lists the main viral infections, according to apparatus involved, that may arise, also with reference to the time elapsed since transplantation. The most up-to-date diagnostic possibilities for each infection are reviewed together with some indications on therapy which may subsequently be examined in greater detail.

Topics: Acyclovir; Age Factors; Child; Child, Preschool; Gastrointestinal Diseases; Heart Transplantation; Humans; Immunoglobulins; Immunosuppressive Agents; Infant; Infant, Newborn; Kidney Transplantation; Lymphoproliferative Disorders; Pneumonia, Viral; Skin Diseases, Infectious; Urinary Tract Infections; Virus Diseases

A 75-year-old woman presented with new onset of confusion, intense episodic dizziness and formed visual hallucinations. Herpes simplex encephalitis and non-convulsive temporal lobe seizures were confirmed with cerebrospinal fluid (CSF) and electroencephalography testing. In addition, her hospital course was complicated by syndrome of inappropriate antidiuretic hormone secretion and atonic bladder contributing to an episode of urinary tract infection. After completing 3 weeks of acyclovir treatment, the patient became obtunded with right arm choreiform movements and persistent inflammatory CSF findings not attributable to persistent herpes simplex virus infection or other confounding factors. The patient responded to steroid treatment. Repeated autoimmune and paraneoplastic evaluations were negative. Both clinical (cognitive testing and atonic bladder) and CSF inflammatory finding improved in the follow-up period.

Topics: Acyclovir; Aged; Antiviral Agents; Chorea; Electroencephalography; Encephalitis; Encephalitis, Herpes Simplex; Female; Glucocorticoids; Humans; Inappropriate ADH Syndrome; Methylprednisolone; Seizures; Urinary Bladder, Underactive; Urinary Retention; Urinary Tract Infections

Acute liver failure (ALF) is rare in children but carries high mortality. Infectious complications (IC) in adults are an important cause of mortality; however, there are few data in the pediatric population. The aim of the study was to determine the incidence of IC and their effects on the outcome in children with ALF.. The present study is a retrospective review of the case records of children presenting with ALF to our center. All patients with ALF received antibiotics and antifungal as prophylaxis from day 1 and high-dose acyclovir was given to neonates only (stopped when herpes simplex was ruled out). Biochemical parameters, duration of ventilation and intensive care, overall hospital stay, and patient outcome were compared between patients with IC and non-IC.. A total of 145 children (78 boys), median (range) age 4.22 (1 day-16 years) years, were studied. Thirty-seven of 145 (25%) patients had proven IC. The predominant infections included 14 episodes of bacteremia in 13 patients and lower respiratory tract infection and urinary tract infection in 10 and 8 patients, respectively. IC occurred in patients after a median (range) duration of 16 (0-54) days of admission. Median (range) duration of hospital stay in patients with IC was 38 (1-201) days and was significantly higher than in those without IC (10 [1-74] days), P < 0.0001. Overall mortality was 21% (31), of which 7% (11) was from the IC group and 14% (20) from the non-IC group; the difference was not statistically significant.. Infections were more frequent after 2 weeks of admission. Patients with sepsis had longer hospital stays and prolonged ventilation. Invasive fungal infections were rare in pediatric ALF with adequate doses of antifungal prophylaxis.

Topics: Acyclovir; Adolescent; Anti-Bacterial Agents; Antifungal Agents; Bacteremia; Child; Child, Preschool; Female; Humans; Incidence; Infant; Infant, Newborn; Length of Stay; Liver Failure, Acute; Male; Mycoses; Respiratory Tract Infections; Retrospective Studies; Urinary Tract Infections; Ventilation

Topics: Acyclovir; Antiviral Agents; Blood Coagulation Disorders; Female; Fibrin; Herpes Zoster; Humans; Hyperlipidemias; Infarction, Middle Cerebral Artery; Lymphangiectasis, Intestinal; Middle Aged; Paraproteinemias; Protein S; Protein-Losing Enteropathies; Urinary Tract Infections