acyclovir / Generic mfg. - LARVOL DELTA

INCIDENCE AND RISK FACTORS OF HERPES ZOSTER INFECTION IN PEDIATRIC SYSTEMIC LUPUS ERYTHEMATOSUS: A 16 YEAR STUDY (EULAR 2025) - "The median Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) at herpes zoster diagnosis was 4 (IQR = 0 – 12), 16.39% had recurrent HZI, 11.48% had superimposed bacterial infection, and more than two-thirds were treated with the anti-viral acyclovir or valacyclovir (88.52%). The prevalence and incidence of HZI in cSLE is 15.72% and 38.40 per 100 person-years, respectively. Risk factors identified for HZI among cSLE were lymphopenia, lupus nephritis, and immunosuppressive agents. In particular, IV cyclophosphamide, azathioprine, and glucocorticoid dose of ≥5mg increased the risk for development of HZI by 1.61, 2.07, 10.20 times, respectively."

Clinical • Glomerulonephritis • Herpes Zoster • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Pediatrics • Rheumatology • Systemic Lupus Erythematosus • Varicella Zoster

CMV and EBV reactivation compared to low T helper and cytotoxic T cells with the focus on therapy safety after autologous stem cell transplantation in patients with systemic sclerosis (EULAR 2025) - P2 | "Patients were transplanted with a conditioning regimen with either cyclophosphamide/ATG or Thiotepa/cyclophosphamide/ATG according to the cardiac manifestation (AST MOMA study protocol, Trial. In our analysis, we observed CMV or EBV reactivation in none of our patients. Following the discussion about therapy safety focusing on virus re-infections after HSCT, even in patients with low T helper and cytotoxic T cells prior to HSCT. In addition, it is important to mention that all patients underwent an anti-viral prophylaxis with aciclovir and co-trimoxazole during our two-year observing time period."

Clinical • Bone Marrow Transplantation • Cytomegalovirus Infection • Immunology • Infectious Disease • Scleroderma • Systemic Sclerosis • Transplantation • CD4 • CD8

Investigation of β-Carboline Alkaloid Harmaline Against Cyvirus cyprinidallo3 Infection In Vitro and In Vivo. (PubMed, Viruses) - "Only around 50% inhibition was observed in cells treated with the common anti-herpesvirus drug acyclovir (ACV) at 10 or 20 µM for 2 h following 1 h post-infection of ~500 PFU/plate...In addition, IM injection of HAL at 20 µM can reduce the rate of CyHV-3 reactivation induced by heat stress in latently infected koi. This study demonstrated that HAL could potentially be used to prevent CyHV-3 infection or reactivation from latency."

Journal • Preclinical • Infectious Disease

SEVERE HEADACHE AND DROWSINESS IN AN IMMUNOCOMPROMISED POST HEMATOPOIETIC STEM CELL TRANSPLANTED ADOLESCENT. (ESPID 2025) - "He received prophylaxis with trimethoprim-sulfamethoxazole, posaconazole and acyclovir...On day +55, he developed a low-grade gastrointestinal graft-versus-host disease (GVHD), which prompted the initiation of immunosuppressive therapy with ruxolitinib, cycloporine and methylprednisolone...Empiric treatment with meropenem 40 mg/kg/day, liposomal amphotericin B 5 mg/kg/day and trimethoprim-sulfamethoxazole 20 mg/kg/day was initiated...Learning Points/Discussion It is crucial to consider a wide range of diagnoses in post-transplant patients presenting with infectious symptoms. Toxoplasma should be considered in immunocompromised individuals, especially if they are immune."

Infectious Disease

Human pegivirus detected in patient with reversible severe encephalitis and axillary lymphadenopathy: a case report. (PubMed, Diagn Pathol) - "After receiving treatment with acyclovir, meropenem, and ceftriaxone sodium, the patient fully recovered. This case contributes additional evidence in support of the hypothesis regarding the pathogenic potential of HPgV and highlights the diagnostic utility of mNGS in detecting rare pathogens."

Journal • CNS Disorders

Underestimated virus impaired cognition-more evidence and more work to do. (PubMed, Front Immunol) - "Even though there is limited clinical evidence to support the use of antiviral medications and their dose regimens within the central nervous system (CNS), with the exception of acyclovir, they are currently utilized to treat various viral CNS infections...It may also be helpful in the search for new antiviral drugs, which are crucial for better managing these neurotropic viral infections. This review focuses on new findings linking viral infection to NDs and explores how viral modifications of cellular functions can impact the development of neurodegeneration and will also explore the therapeutic potential of antiviral drugs in NDs."

Journal • Review • Alzheimer's Disease • CNS Disorders • Dementia • Infectious Disease • Inflammation

The critical role of early diagnosis, multidisciplinary management, and social determinants in severe eczema herpeticum: a case study of a 24-year-old man (SID 2025) - "A 24-year-old male, with a history of atopic dermatitis previously well controlled with dupilumab, presented to the emergency department with a four-week history of painful, pruritic skin vesicles and erosions, which had progressed to crusted plaques affecting his face, neck, chest, arms, and thighs...Eczema herpeticum was suspected and he was started on empiric acyclovir 5mg/kg IV every 8 hours...Due to periocular impetiginization, ophthalmology was consulted, and mupirocin ointment was applied twice daily to the face...Within five days, the patient showed clinical improvement, was transitioned to oral valacyclovir, and connected to multidisciplinary outpatient services for continuity after discharge...Disclaimer: This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or..."

Case study • Clinical • Atopic Dermatitis • Dermatitis • Dermatology • Herpes Simplex • Immunology • Ophthalmology • Pain

Insult to Injury: Herpes Simplex Virus-induced Airway Obstruction Complicating Post-traumatic Bronchial Stenosis - A Rare Case (ATS 2025) - "Antiviral treatment with Acyclovir was initiated, with follow-up imaging and bronchoscopy showing improved lung aeration and reduced inflammatory debris in the airway...Due to the unique HSV involvement, a tailored, multidisciplinary approach involving infectious disease and pulmonology was essential for guiding management. This case reinforces that, in the absence of standardized protocols, a patient-specific, multidisciplinary approach is paramount for managing delayed post-traumatic airway stenosis effectively."

Clinical • Herpes Simplex • Musculoskeletal Diseases • Orthopedics • Pulmonary Disease • Respiratory Diseases

Fatal Neuroinvasive Jamestown Canyon Virus in an Immunocompetent Patient (ATS 2025) - "She was initially treated empirically with broad-spectrum antimicrobials, including vancomycin, ceftriaxone, ampicillin, acyclovir, and fluconazole, for suspected infectious encephalitis. This patient's hemorrhagic complications underscore a possible, underexplored impact of JCV on CNS vascular integrity. This case illustrates the diagnostic and therapeutic challenges posed by JCV, emphasizing the need for further research to understand its full clinical spectrum and to develop potential management strategies, particularly as ecological changes may expand JCV's range and impact."

Clinical • Ataxia • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Immunology • Infectious Disease • Movement Disorders • Pain

Vitamin Vortex: A Rare Case of Scurvy and Concurrent Deficiency (ATS 2025) - "Given concerns for a central nervous system infection, the patient was initiated on broad-spectrum antibiotics and acyclovir... Scurvy can present in complex and atypical ways, particularly in older adults. Clinicians must remain vigilant for signs of nutritional deficiencies, as timely diagnosis and intervention are crucial for improving patient outcomes. This case underscores the importance of recognizing the multifaceted nature of nutritional deficiencies in clinical practice."

Clinical • Acute Kidney Injury • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Dermatology • Dyslipidemia • Fatigue • Hematological Disorders • Hypertension • Infectious Disease • Inflammation • Nephrology • Renal Disease • Rheumatology • Thrombocytopenia • Vasculitis

When Innovation Meets Inflammation: A Case of Reactive Airway Disease Due to 3D Printer Emissions (ATS 2025) - "Case report: A 38-year-old female with a past medical history of genital herpes on acyclovir presented to the clinic for evaluation of a persistent cough with "dark spots in her sputum" and frequent throat clearing...Ensuring proper ventilation and monitoring air quality can help mitigate the potential health risks associated with 3D printer emissions. Ongoing research into the long-term effects of exposure and developing comprehensive guidelines for safe 3D printing practices is essential in protecting respiratory health and preventing associated conditions."

Clinical • Chronic Cough • Cough • Infectious Disease • Inflammation • Respiratory Diseases

Abdominal Pain in an Immunocompromised Lung Transplant Recipient Leading to Pneumaturia (ATS 2025) - "His immunosuppressive regimen consisted of mycophenolic acid, prednisone, and tacrolimus, along with prophylactic acyclovir/letermovir, bactrim, and itraconazole...He was empirically treated with piperacillin and tazobactam, which was transitioned to amoxicillin/clavulanate on discharge...Broad spectrum antibiotics alone are often insufficient. Our patient recognized pneumaturia quickly, leading to a timely intervention with a good outcome."

Clinical • Gastrointestinal Disorder • Hematological Disorders • Idiopathic Pulmonary Fibrosis • Immunology • Infectious Disease • Leukopenia • Pain • Pulmonary Disease • Respiratory Diseases • Septic Shock • Transplantation • Urology

Syndrome of Inappropriate ADH Secretion (SIADH) in the Setting of Varicella Zoster Infection Exacerbated by Acyclovir (ATS 2025) - "The exact mechanism of Acyclovir-induced SIADH is still unknown and needs further research. Awareness of this association leads to early diagnosis and frequent monitoring and appropriate treatment."

Addiction (Opioid and Alcohol) • Cardiovascular • CNS Disorders • Heart Failure • Herpes Simplex • Herpes Zoster • Infectious Disease • Varicella Zoster

Severe Acute Respiratory Distress Syndrome (ARDS) in an Infant With Disseminated Herpes Simplex Virus Pneumonitis (ATS 2025) - "The infant was started on ampicillin-sulbactam and gentamycin for suspected neonatal sepsis...Studies however suggest that only 84% of infants receive acyclovir when neonatal sepsis is suspected, despite untreated neonatal HSV having an 80% mortality rate (2)(3). This case highlights the need for heightened awareness and consideration of HSV in neonatal care to improve outcomes. Further research is needed for evaluation of maternal suppressive therapy and association with neonatal HSV."

Acute Respiratory Distress Syndrome • Herpes Simplex • Inflammation • Pediatrics • Pneumonia • Respiratory Diseases • Septic Shock • CRP

Management of Status Epilepticus and Acute Respiratory Distress Syndrome (A.R.D.S) Via a Remote Tele-intensivist Program in a Safety-net Community Hospital (ATS 2025) - "Based on consultations with Neurology and Infectious Disease, the patient was initiated on broad-spectrum antibiotics (Ceftriaxone, Vancomycin, Acyclovir), antipyretics, and anti-epileptic agents (Phenytoin, Levetiracetam, and Lorazepam). The expertise of a remote tele-intensivist, combined with a well-coordinated team, facilitated evidence-based critical care in an underserved setting. This report underscores Tele-ICU programs as effective, sustainable, and cost-efficient solutions for improving access to board-certified intensivists, benefiting resource-limited communities."

Clinical • Acute Respiratory Distress Syndrome • Anesthesia • Cardiovascular • Developmental Disorders • Diabetes • Epilepsy • Hypotension • Infectious Disease • Metabolic Disorders • Otorhinolaryngology • Pneumonia • Respiratory Diseases • Septic Shock • Type 2 Diabetes Mellitus

A Rare Case of Pulmonary and Gastric Malt Lymphoma in a Patient Presenting With Recurrent Microcytic Anemia (ATS 2025) - "The patient was started on combined Bendamustine and Rituximab therapy...Prophylactic was initiated with Bactrim and Acyclovir...Treatment options vary based on disease extent; radiation may be effective for localized MALT lymphoma, while immunochemotherapy is preferred for widespread disease. In this case, combined immunochemotherapy was initiated given the presence of both gastric and pulmonary involvement."

Clinical • Anemia • B Cell Lymphoma • Extranodal Marginal Zone Lymphoma • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Lymphoma • Marginal Zone Lymphoma • Oncology • Pain • MALT1

Leptospirosis in the Concrete Jungle: A Case Report in an Urban Setting Presenting With Septic Shock and Encephalitis (ATS 2025) - "He was treated with vancomycin, ceftriaxone and azithromycin to cover for community acquired pneumonia and acyclovir with ampicillin-sulbactam to cover for meningitis/encephalitis. As climate change and urbanization brings greater areas of warm and humid environments and exposure to this organism, leptospirosis is estimated to increase in global burden. A heightened awareness of the disease through careful consideration of patient demographics, epidemiological factors and clinical features should allow for early detection of disease."

Case report • Clinical • Acute Kidney Injury • Addiction (Opioid and Alcohol) • Anesthesia • CNS Disorders • Hepatology • Human Immunodeficiency Virus • Inflammation • Musculoskeletal Pain • Pain • Pneumonia • Renal Disease • Respiratory Diseases • Septic Shock

Swiss Cheese Model: Brain Abscesses Associated With Listeria Monocytogenes (ATS 2025) - "Herein, we report the case of a 79-year-old patient without immunocompromising condition or recent exposures who presents with altered mental status preceded by fever, headache, and hematemesis who had been receiving outpatient treatment for a urinary tract infection with cephalexin...The patient initially received Vancomycin, Ceftriaxone, Ampicillin, and Acyclovir but following the negative Meningitis/Encephalitis Panel, which has a >90% sensitivity, this was tailored after hospital day 1 to Vancomycin and Ceftriaxone. They subsequently received a full course of dexamethasone for meningitis without improvement in neurologic status...Additionally, with increased awareness of Listeria as an etiology of brain abscesses, earlier MRI imaging may have been pursued for this patient's case. Future considerations include managing antimicrobial stewardship as well as determining optimal timing and patient population for advanced imaging."

CNS Disorders • Hematological Disorders • Immunology • Infectious Disease • Nephrology • Pain

A Case of Hydroxychloroquine Associated Catatonia in SLE (ATS 2025) - "Empiric antibiotic therapy was initiated with vancomycin, cefepime and acyclovir...Patient was back to baseline with scheduled lorazepam, antibiotics were de-escalated, and she was transferred to inpatient psychiatry...A literature review in Coronavirus-19 patients found several case reports of mania with hydroxychloroquine and chloroquine exposure...Our patient tested positive for this allele but did not meet the criteria for narcolepsy. Further research into the genetic predisposition of catatonia may help guide patient selection when starting hydroxychloroquine."

Clinical • Bipolar Disorder • Cardiovascular • CNS Disorders • Depression • Dermatology • Infectious Disease • Inflammatory Arthritis • Insomnia • Lupus • Mental Retardation • Mood Disorders • Myocardial Infarction • Narcolepsy • Novel Coronavirus Disease • Oncology • Psychiatry • Sleep Disorder • Systemic Lupus Erythematosus • HLA-DQB1

Valacyclovir Toxicity in ESRD Unmasked by Thorough History in Intubated Patient (ATS 2025) - "An EEG confirmed epileptiform activity, and she was treated with Keppra and Vimpat...Her ICU stay was prolonged by failed spontaneous breathing trials (SBTs), and she showed minimal response to modafinil on Day 14...Neurotoxicity arises from the accumulation of acyclovir's active metabolite, which, without adequate renal clearance, crosses the blood-brain barrier and leads to encephalopathic symptoms, as seen in this patient... The patient's condition improved following discontinuation of valacyclovir and ongoing dialysis. This case emphasized the critical role of careful medication management in ESRD patients, particularly for drugs like valacyclovir that have neurotoxic potential."

Clinical • Anesthesia • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Epilepsy • Heart Failure • Herpes Zoster • Infectious Disease • Movement Disorders • Nephrology • Psychiatry • Renal Disease • Varicella Zoster

Beyond Bacteria: Recognizing and Treating HSV Pneumonitis in Critically Ill Patients (ATS 2025) - "A bronchoscopy revealed HSV-1 infection, prompting the initiation of intravenous acyclovir (10 mg/kg every 8 hours)... Our findings highlight the importance of vigilance for viral etiologies, including HSV pneumonitis, in critically ill patients unresponsive to standard treatment. Aligning with emerging evidence, this case supports the early use of antivirals in HSV pneumonitis to enhance recovery, suggesting the need to reconsider conventional guidelines against their use."

Clinical • Herpes Simplex • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Pneumonia • Septic Shock

Varicella Zoster Virus Infection Leading to Concomitant Pneumonia and Myocarditis in a Young Immunocompromised Patient (ATS 2025) - "Upon admission, he was started on ceftriaxone, azithromycin, acyclovir, and hydrocortisone stress doses. We argue that VZV myocarditis should remain high on the differential in the correct clinical setting. Additionally, future studies should be done to establish best diagnostic testing and whether acyclovir dosing should change in myocarditis patients."

Clinical • Anesthesia • Cardiovascular • Congenital Adrenal Hyperplasia • Endocrine Disorders • Herpes Zoster • Infectious Disease • Inflammation • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases • Varicella Zoster

Varicella-Zoster Virus (VZV) Pneumonia: A Cannot Miss Diagnosis in an Immunocompromised Patient Presenting With a Diffuse Vesicular Rash (ATS 2025) - "This abstract is funded by: None A 44-year-old female with a past medical history of renal transplant (on mycophenolate, prednisone for immunosuppression) for Goodpasture syndrome presented for several days of abdominal pain, nausea, and vomiting...The patient was also noted to have an elevated beta-D-glucan, a later respiratory culture with pseudomonas, and a positive serum CMV PCR, and was therefore treated with isavuconazonium, meropenem, and ganciclovir, respectively...In addition, this case shows a potential way to navigate respiratory coinfections alongside VZV in an immunocompromised patient, as seen here in managing fungal, bacterial, and additional viral etiologies of coinfection. Furthermore, this case also demonstrates a situation where acyclovir and VZV IgG were successfully used to treat a patient critically ill from disseminated VZV, adding further support for IVIG as an effective adjunctive therapy to acyclovir when VZV pneumonia is complicated by ARDS."

Clinical • Acute Respiratory Distress Syndrome • Cytomegalovirus Infection • Fibrosis • Herpes Zoster • Immunology • Infectious Disease • Pain • Pneumonia • Respiratory Diseases • Varicella Zoster

Rhinovirus: A Rare Trigger for Cerebral Venous and Arterial Thrombosis (ATS 2025) - "The patient was intubated for airway protection and subsequently underwent lumbar puncture and was started empirically on Ceftriaxone, Vancomycin, and Acyclovir. We hypothesize that acute sinusitis from rhinovirus infection predisposed our patient to developing CSVT. In patients with upper respiratory viral infections and new onset neurologic symptoms, a thorough investigation should be done, and CVST should always be ruled out, given its high mortality and morbidity."

Acute Respiratory Distress Syndrome • Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Infectious Disease • Inflammation • Novel Coronavirus Disease • Otorhinolaryngology • Pain • Respiratory Diseases • Sinusitis • Thrombosis

HSV1 Pneumonia With Airway Hemorrhage in a Pediatric Patient With GRIN2D Mutation (ATS 2025) - "Tranexamic acid (TXA) was administered for 48 hours to control airway bleeding...The patient was treated with acyclovir for a total of three weeks and amoxicillin-clavulanate to manage potential bacterial superinfection for a total of four weeks...HSV1 tracheobronchitis has not been described in a pediatric patient and this is the first known description of its association with severe airway hemorrhage. [asterisk]AI was used to refine this case report, with all content reviewed by the authors[asterisk]"

Clinical • Cerebral Palsy • CNS Disorders • Epilepsy • Hematological Disorders • Herpes Simplex • Infectious Disease • Pediatrics • Pneumonia • Respiratory Diseases • GRIN2D