Successful oral acyclovir desensitization.

A 65-year-old woman with the acquired immunodeficiency syndrome (AIDS) complicated by recurrent mucocutaneous herpes simplex virus (HSV) infection developed angioedema on the initiation of her second course of oral acyclovir therapy. Oral rechallenge in hospital three days later confirmed acyclovir hypersensitivity. Vidarabine and foscarnet therapies were abandoned after treatment failure and unacceptable toxicity. Acyclovir desensitization was accomplished using a protocol derived from oral penicillin desensitization regimens. Mucocutaneous HSV infection responded to intravenous acyclovir followed by chronic oral suppression without recurrences of HSV or hypersensitivity. This report is an example of acyclovir hypersensitivity and successful oral desensitization.

CNS tumors: supportive management of the patient and family.

Malignancies of the central nervous system (CNS) present unique and serious challenges to patient, family, and caregiver. The incidence of CNS malignancies is growing, as individuals are living longer with cancer, and many CNS tumors are metastatic. Regardless of etiology, tumors of the cranium and spinal canal require ongoing assessment, intervention, and supportive management. Yet, even with advances in overall therapeutic modalities, successful treatment of CNS malignancies remains elusive. This paper discusses supportive management of the individual with a CNS tumor.

Ethical issues in cancer care: conclusion.

Ethical issues permeate every aspect of cancer nursing care. The articles in this issue have presented the more urgent concerns that involve most nurses. As cancer nurses, we have a responsibility to confront these issues and be prepared for future issues. The challenge is ours, for our patients and our profession.