Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

Miller, Geraldine G.; Dummer, J. Stephen

doi:10.1111/j.1600-6143.2006.01718.x

Cited by 102 publications

(69 citation statements)

References 73 publications

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“…Organ nakilli hastalarda primer VZV enfeksiyonu nadirken, herpes zoster bu hasta grubunda daha sıklıkla izlenmektedir. İmmün sistemi baskılanmış olan bu hastalarda VZV reaktivasyon riski normal popülasyona göre artmıştır (6). …”

Section: Discussionunclassified

Varicella Zoster Infection Under Valganciclovir Prophylaxis After Renal Transplantation

Bardak¹,

Turgutalp²,

Koyuncu³

et al. 2016

Turk Neph Dial Transpl

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özBöbrek nakilli hastalara uygulanan yoğun immünsüpresif tedavi bir çok enfeksiyon hastalığı riskinde artışa neden olmaktadır. Bu enfeksiyonlar arasında yer alan varisella virüs enfeksiyonu (VZV) primer veya reaktivasyona ikincil olarak yaygın deri tutulumu veya spesifik doku ya da organ tutulumu ile seyredebilmektedir. Yaygın VZV enfeksiyonuna bağlı mortalite %30'a varabilmektedir. Sitomegalovirüs (CMV) profilaksisi amacıyla kullanılabilen ve geniş spektrumlu antiherpetik bir ajan olan valasiklovir ve valgansiklovir CMV'ye ek olarak herpes simpleks virüs (HSV), VZV gibi diğer herpesvirüs enfeksiyonlarına karşı da koruyucu olduğu düşünülmektedir. Burada, çocukluk çağında VZV enfeksiyonu geçirmemiş olan ve böbrek naklinden 5½ ay sonra, valgansiklovir profilaksisi altında gelişen ve yaygın deri, karaciğer ve sol göz tutulumu gösteren VZV enfeksiyonlu hasta ve yönetimi sunulmuştur.anahTaR SözCüklER: Renal transplantasyon, Valgansiklovir, Valasiklovir, Varisella aBSTRaCT Intensive immunosuppressive therapy in renal transplant patients increases the risk for infectious diseases. Varicella zoster virus (VZV) infection is one of these infectious diseases and can occur either primarily or with reactivation of latent disease with disseminated skin lesions or visceral involvement. Mortality rate due to disseminated VZV infection is as high as 30%. Valacyclovir and valganciclovir, which are wide spectrum antiherpetic agents used for cytomegalovirus (CMV) prophylaxis, act against not only CMV but also herpes simplex virus (HSV) and VZV. We describe a patient who did not have a VZV infection history in childhood and suffered from disseminated VZV infection with skin, liver and left eye involvement 5½ months after renal transplantation under valgancyclovir prophilaxis for CMV, and discuss the management of primary VZV infection. GirişBöbrek nakilli hastalarda, gerek klasik gerekse fırsatçı mikroorganizmalarla gelişen enfeksiyon riski artmıştır. Bu özel hasta grubunda enfeksiyonlar, kardiyovasküler nedenlerden sonra 2. sıklıkta izlenen ölüm nedenidir. Böbrek nakli sonrasında özellikle 1-6. aylar arasında yoğun immünsüpresyonun katkısıyla sitomegalovirüs (CMV), herpes simpleks virüs (HSV), varisella zoster virüs (VZV), epstein-barr virüs (EBV), hepatit B ve C gibi viral enfeksiyonlar primer olarak veya latent enfeksiyonun reaktivasyonu ile gelişebilmektedir (1).Böbrek nakli olan hastalarda primer veya reaktivasyona ikincil gelişen VZV enfeksiyonu yaygın deri tutulumu veya spesifik doku ya da organ tutulumu ile seyredebilmektedir. Bu hasta grubunda yaygın VZV enfeksiyonuna bağlı mortalite oranı %30'a ulaşabilmektedir (2). CMV enfeksiyon riskini azaltmak amacıyla uygulanabilen bazı profilaktik yaklaşımların VZV'ye karşı da koruyucu olabileceği bilinmektedir (3).

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Section: Discussionunclassified

Varicella Zoster Infection Under Valganciclovir Prophylaxis After Renal Transplantation

Bardak¹,

Turgutalp²,

Koyuncu³

et al. 2016

Turk Neph Dial Transpl

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“…Our results demonstrated a low prevalence of VZV infection in renal transplant recipients (3.51%) compared with other studies that reported a prevalence of 3% to 10%. 3,4 Previous studies showed that female sex was a risk factor for developing HZ in liver transplant recipients, but 63% renal transplant patients who developed VZV infection were male. 3 The frequency and intensity of VZV infection is associated with the intensity of immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

“…In solid-organ transplant recipients, the incidence of reactivation is 10-to 100-fold higher than the general population, ranging from 1% to 12%. 3,4 The typical clinical presentation of zoster is a painful, localized, unilateral, vesicular rash involving ≤ 2 adjacent dermatomes. 2 The VZV is an important pathogen after renal transplant.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Outcome of Herpes Zoster Infection in Renal Transplant Recipients

Kırnap

Akdur²,

Soy³

et al. 2015

Exp Clin Transplant

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“…In patients with severe primary or generalized varicella-zoster virus infection, and in rare patients with disseminated herpes simplex infection, the use of an antiviral agent, such as acyclovir, can be highly effective if started early in the course of infection. 49 Antimicrobial treatment should be reassessed daily for potential de-escalation to prevent the development of resistance, to reduce toxicity, costs, and the development of superinfection by other pathogenic or resistant organisms such as Candida species, Clostridium difficile or vancomycin-resistant Enterococcus faecium. However, in some cases 11 (Pseudomonas species, only susceptible to aminoglycosides; enterococcal endocarditis; Acinetobacter species susceptible only to polymyxins), it is recommended to continue with a specific combination of antimicrobials.…”

Section: Antibioticsmentioning

confidence: 99%

Management of sepsis: from evidence to clinical practice

et al. 2016

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Sepsis is one of the leading causes of death in hospitalized patients and its management involves a lot of specialist. Internist is required to demonstrate his competence since the beginning when the diagnosis is not so easy to be clarified. A rapid clinical suspicion permits a prompt management of the patient that means important mortality reduction. However, it is essential to understand the source of infection and echography represents a rapid, economic, useful and widespread tool with whom Internist should become more and more confident. The following review is a practical guide to manage septic patients according to the most recent literature, underlining aspects of antibiotic therapy, hemodynamic stabilization and supportive therapy. To limit sepsis mortality, a valid Internist should be culturally prepared and especially able to cooperate with other specialists, because a strong enemy requires a strong team.

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Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

Cited by 102 publications

References 73 publications

Varicella Zoster Infection Under Valganciclovir Prophylaxis After Renal Transplantation

Varicella Zoster Infection Under Valganciclovir Prophylaxis After Renal Transplantation

Prevalence and Outcome of Herpes Zoster Infection in Renal Transplant Recipients

Management of sepsis: from evidence to clinical practice

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