experience of oral acyclovir in treating children with varicella infection

To study the morbidity and complications of varicella infection in patients treated with acyclovir. It is a descriptive observational study conducted at Paediatric out patient department of Civil Hospital Karachi during September 1997 to March 1998. Alt children between the ages of 2-15 years presenting with clinical features of varicella but healthy otherwise and of average weight, and presenting within 72 hours of the onset of rash were treated with oral acyclovir in a dose of 80 mg/ kg/ day for five days. At the end of five days the patients were evaluated for the duration of illness, severity of rash and itch and development of complications. The patients were also assessed for the side effects of the drug. Cost of the treatment was also calculated. A total of 31 children, 15 mate and 16 females were studied. After the treatment the fever remained for 1- 8 days [mean 3.12 days]. Eighteen [58%] patients had a moderate rash. Six [19.3%] had a severe rash while in seven [22%] the rash was of mild nature. Twenty [64.5%] of the patients had a moderate itch while five patients each [16.1%] had mild and severe itch. New rash continued to appear for three to nine days [mean 3.3 days]. Complications were noted in three [6.9%] patients' only and included otitis media, pneumonia and secondary bacterial infection of vesicular lesions in one patient each. None of the patients developed any side effects to the drug. The average cost of treatment was Rs.3269/=. Use of oral acyclovir in varicella infection [chicken pox] seems to limit new rash formation and total duration of illness to an average of

Neumonía por varicela en adultos / Varicella pneumonia in adults

La neumonía por varicela es una rara complicación en el curso de una Varicela (10-20 por ciento) de ocurrencia preferentemente en adultos e inmunocomprometidos, potencialmente mortal, de curso variable y parcialmente prevenible. La neumonía por varicela se presenta en los primeros días del cuadro clínico, puede ser asintomática o generar falla respiratoria y requerir asistencia ventilatoria. Su diagnóstico es clínico y por imágenes; los estudios serológicos (medición de IgM) y de aislamiento viral son complementarios. Pese a la posibilidad de efectuar profilaxis en los huéspedes susceptibles con gamaglobulina o aciclovir, la medida más costoefectiva es la vacunación, disponible en Chile. Una vez desencadenado el cuadro, las medidas terapéuticas son restringidas, consistente en aciclovir o valaciclovir usados precozmente y medidas de soportes ventilatorio de ser necesario. Pese a la falta de evidencias sólidas respecto al uso de corticoides, su beneficio parece superar el riesgo involucrado en su uso

Viremia VHC e infección por virus herpes zoster en un paciente en hemodiálisis tratada con eritropoietina / VHC viremia and herpes zoster infection in a patient in hemodialysis treated with erythropoietin

Hepatitis C virus infection in chronic hemodialysis patients is associated with several unresolved problems. We report a 85 years old female patient in chronic hemodialysis and treated with erythropoietin, that during the course of an Herpes zoster, presented severe malaise, weight loss and muscle weakness. Two weeks later, a slight rise in serum transaminases was detected. The patients had a negative antibodies for HIV and hepatitis C virus and negative hepatitis B surface antigen. A PCR test was positive for serum hepatitis C virus RNA. The patient's condition deteriorated and she died 7 days after admission. Erythropoietin administration, whose immunosupressive effect has been reported previously, could have influenced the dismal outcome of this patient

Effects of human alpha, beta and gamma interferons on varicella zoster virus in vitro.

The antiviral effects of interferon (IFN) on varicella zoster virus (VZV) and herpes simplex virus (HSV) in vitro were examined. The values for the 50% inhibitory dose (ID50) of IFN-alpha, beta and gamma determined by plaque reduction assay, were 0.813, 0.650 and 13.750 IU/ml, respectively, against VZV and 18.00, 10.38 and 115.0 IU/ml, respectively, against HSV. Thus IFN-alpha and beta were more effective than IFN-gamma against both VZV and HSV and VZV was more sensitive than HSV to the IFNs. Five mutants of VZV which were resistant to acyclovir (ACV), phosphonoacetic acid (PAA) or bromodeoxyuridine (BUDR) were also sensitive to IFN beta, their average ID50 being 1.31 IU/ml. Analysis of virus-specific proteins by the immunofluorescent technique with various antisera showed that IFN had a significant effect before early protein synthesis.

Varicella and Herpes zoster infections in immunocompromised host: prevention and treatment

Las infecciones por el virus de Herpes, específicamente Varicella-Herpes zoster, presentan problemas particulares a los pacientes inmunocomprometidos. Cuando se comparan con los inmunológicamente competentes, estos tipos de pacientes son más propensos al desarrollo de complicaciones, como lo son el aumento en duración de las neuralgias, cicatrización lenta de las lesiones cutáneas, envolvimiento visceral e infecciones diseminadas. Los intentos para la prevención están todavía en fase experimental y las vacunas no se han desarrollado bien; la profilaxis con inmunoglobulinas e interferón no ha sido impresionante. En cuanto al tratamiento, parece ser que el tratamiento por vía parenteral (IV) con vidarabina o acyclovir es efectivo, ya que reduce la duración de la fiebre, disminuye el número y aparición de nuevas lesiones, promueve la cicatrización y disminuye el compromiso visceral y las complicaciones en general