Herpes simplex, disseminated

Catechins and proanthocyanidins have a documented antiviral activity. Catechins from an extract of Cocos nucifera husk fibre exhibited a strong inhibitory activity against acyclovir-resistant herpes simplex virus type 1 (HSV-l-ACVr) [62]. The use of 10 to 20ngml of ECG and EGCG has been reported to cause 50% inhibition of human immunodeficiency virus reverse transcriptase [89], while Kara and Nakayama [90] reported that a patented chewing gum containing tea catechins is claimed to prevent viral infections against influenza and to inhibit dissemination of this virus. 

Cytomegalovirus retinitis (with loss of vision) Encephalopathy, HIV-related Herpes simplex chronic ulcer(s) (duration >1 month) or bronchitis, pneumonitis, or esophagitis Histoplasmosis, disseminated or extrapulmonary Isosporiasis, chronic intestinal (duration >1 month) Kaposi s sarcoma... 

Herpes simplex - For severe disease that requires hospitalization (eg, disseminated infection, pneumonitis, hepatitis, meningitis, encephalitis) IV acyclovir therapy is recommended. 

Intravenous acyclovir is the treatment of choice for herpes simplex encephalitis, neonatal HSV infection, and serious HSV or VZV infections (Table 49-1). In immunocompromised patients with VZV infection, intravenous acyclovir reduces the incidence of cutaneous and visceral dissemination. 

Hajri, A., Wack, S., Lehn, P., Vigneron, J.P. and Lehn, J.M. (2000) Efficient transfer of double suicide genes (herpes simplex virus-thymidine kinase and Escherichia coh-CD) into peritoneal disseminated pancreatic tumor cells by the cationic lipid BGTC. Cancer Gene Ther., 7,1393-1393. 

Parenteral acyclovir is the drug of choice for the treatment of initial and recuiTent mucosal or cutaneous herpes simplex infections in immunocompromised patients and for the treatment of disseminated, neonatal, encephalitic, and severe first episodes of genital herpes simplex infections in immunocompetent patients (Whidey, 1997). Ind avenous acyclovir should also be used for severe diseases such as encephalids (Brady and Bernstein, 2004). 

Disseminated infection with Herpes simplex vims and Varicella zoster vims occurred in a patient taking thalidomide for relapsed multiple myeloma (95). 

Dissemination of Herpes simplex Dry mucous membranes Epistaxis... 

Ocular antiviral chemotherapy in the horse is adapted from that used in herpes simplex virus (HSV) and varicella zoster keratitis in humans. The agents used are nucleotide analogs capable of inhibiting viral replication by competitive inhibition of the uptake of the nucleotide into the viral genome. These agents are virustatic and require an intact immune system to suppress or eliminate the virus from the eye. They probably do not eradicate any latent infection. The antiviral drugs available currently do not penetrate intact comeal epithelium and are poorly disseminated within the comeal stroma. The availability of these dmgs will vary in different countries and some may only be obtained from hospital pharmacies. 

Disseminated herpes simplex Scabies and insect bites MoUuscum contagiosum... 

Nikkels AF, Delverme P, Sadzot-Delvaux C, et al. Distribution of varicella zoster virus and herpes simplex virus in disseminated fatal infections./ Clin Pathol. 1996 49 243-248. 

Mizuguchi H, Hayakawa T (2002). Enhanced antitumor effect and reduced vector dissemination with fiber-modified adenovirus vectors expressing herpes simplex virus thymidine kinase. Cancer Gene Ther. 9 236-242. 

Vidarabine is used mainly in human HSV-1 and HSV-2 encephalitis, decreasing the mortality rate from 70 to 30%. Whitley et al. (57) reported that early vidarabine therapy is helpful in controlling complications of localized or disseminated herpes zoster in immunocompromised patients. Vidarabine also is useful in neonatal herpes labialis or genitalis, vaccinia virus, adenovirus, RNA viruses, papovavirus, CMV, and smallpox virus infections. Given the efficacy of vidarabine in certain viral infections, the U.S. FDA approved a 3% ointment for the treatment of herpes simplex keratoconjunctivitis and recurrent epithelial keratitis, and a 2% IV injection for the treatment of herpes simplex encephalitis and herpes zoster infections (Table 43.3). A topical ophthalmic preparation of vidarabine is useful in herpes simplex keratitis but shows little promise in herpes simplex labialis or genitalis. The monophosphate esters of vidarabine are more water-soluble and can be used in smaller volumes and even intramuscularly. These esters are under clinical investigation for the treatment of hepatitis B, systemic and cutaneous herpes simplex, and herpes zoster virus infections in immunocompromised patients. 

Shelley WB (1961) Herpetic arthritis associated with disseminated herpes simplex in a wrestler. Br J Dermatol 103 209-212 Shono M, Ezoe K, Kaniwa MA, et al. (1991) Allergic contact dermatitis from pflrfl- er fl 7-butylphenol-formaldehyde resin (PTBR-FR) in athletic tape and leather adhesive. Contact Dermatitis 24 281-288... 

A 49-year-old woman with seronegative rheumatoid arthritis developed pustular psoriasis while taking etanercept and subsequently developed disseminated herpes simplex during infliximab therapy, with fever, a widespread itchy vesicular rash, and worsening inflammatory arthritis [91 ]. 

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