A 79-year-old male with hemodialysis (HD)-dependent end-stage renal disease (ESRD) presented to the emergency department with acute encephalopathy. He had a recent diagnosis of herpes zoster and was prescribed valacyclovir 1 g three times daily. After taking 4 doses, his wife was concerned of new onset confusion. Labs and vitals on admission were unremarkable except for an elevated BP (blood pressure) of 160/82, SCr of 3.54 mg/dL, and a BUN (blood urea nitrogen) of 30 mg/dL. Neurologic examination was significant for disorientation but was otherwise nonfocal. Herpes encephalitis was ruled out as a cause of the patient's confusion given lack of fever, headache, and neck stiffness. Poison control was consulted, and the leading differential was valacyclovir toxicity. The patient was admitted to the ICU (intensive care unit) where nephrology performed 2 intermittent, 6-hour dialysis sessions over 2 consecutive days for drug clearance based on valacyclovir's half-life and the dosage received.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.