ABSTRACT
Bloodstream infection due to herpes simplex virus (HSV) is rare in the immunocompetent host but may be important in the pathogenesis of disseminated HSV infection in the immunocompromised patient. Using a simple blood-culture method, we detected herpes simplex viremia in eight immunologically compromised or immature children: two neonates, two oncology patients, and four transplant recipients. Only two patients initially exhibited evidence of mucocutaneous HSV infection. Blood was cultured for HSV because of perinatal exposure, for routine surveillance, or for the evaluation of fever, esophagitis, or oral lesions in immunocompromised patients. In five cases HSV was recovered only from the blood; in two other instances blood cultures for HSV were the first positive cultures. The time required for the detection of HSV by blood culture ranged from 1 day to 12 days. In one case viremia was transient and cleared without specific therapy. The other seven cases were treated with intravenous acyclovir; in four of these cases, therapy was initiated because of the positive blood culture. The detection of HSV in blood may promote early initiation of antiviral therapy and thereby improve prognosis.
Subject(s)
Herpes Simplex/etiology , Viremia/etiology , Antiviral Agents/therapeutic use , Child, Preschool , Female , Herpes Simplex/complications , Herpes Simplex/drug therapy , Humans , Immunocompromised Host , Infant , Infant, Newborn , Male , Neoplasms/complications , Neoplasms/immunology , Organ Transplantation/adverse effects , Viremia/complications , Viremia/drug therapySubject(s)
Anti-Bacterial Agents/pharmacology , Erythromycin/analogs & derivatives , Mycobacterium avium/drug effects , Mycobacterium tuberculosis/drug effects , Mycobacterium/drug effects , Nontuberculous Mycobacteria/drug effects , Clarithromycin , Erythromycin/pharmacology , Humans , Microbial Sensitivity TestsABSTRACT
The in vitro activity of the quinolone CI-934 was compared with ciprofloxacin, norfloxacin, enoxacin, and vancomycin against 607 Gram-positive and -negative isolates. CI-934 inhibited 90% of the Enterobacteriaceae, Aeromonas hydrophila, and Acinetobacter spp. at 1 microgram/ml. Decreased activity was observed against Pseudomonas aeruginosa. Pseudomonas maltophilia, and other Pseudomonas spp. with CI-934 MIC90 greater than or equal to 8 micrograms/ml. CI-934 activity against Gram-positive organisms exceeded vancomycin and the other quinolones. MIC90 for Streptococcus faecalis, Listeria monocytogenes, and Corynebacterium spp. were less than or equal to 2 micrograms/ml. CI-934 was equally effective against oxacillin-susceptible and -resistant staphylococci with MIC90 of 0.5 micrograms/ml.
