Cytomegalic retinitis, treatment

The lack of effect of available nucleoside analogs on cytomegalovirus (CMV) infection led to the synthesis of the acyclovir analog, ganciclovir [gan SYE kloe ver] (9-[(1,3-dihydroxy-2-propoxy)methyl]guanine, DHPG). It is currently available for treatment of cytomegalic retinitis in immunocompromised patients. 

Antiviral spectrum Its activity in vitro is the same as that of acyclovir, but ganciclovir is approved only for treatment of cytomegalic retinitis. 

A 27- year-old male with a three-year history of AIDS complains of progressive blurring of vision for two days. Eye examination reveals evidence of retinitis consistent with cytomegalic virus inclusion disease. Intravenous treatment is started, and within five days the patient complains of muscular weakness and cramping. Blood chemistries show a creatinine of. 5.2 mEq/L and a Ca of 6.9 mEq/L. 

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