Oral treatment with valacyclovir for HSV-2-associated eczema herpeticum in a 9-month-old infant

Zhuang, Kaiwen; Wu, Qiong; Ran, Xin; Ran, Yuping; Liu, Ding; Xu, Xin; Lei, Song; Lama, Jebina

doi:10.1097/md.0000000000004284

Cited by 9 publications

(4 citation statements)

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“…Prior to the use of acyclovir, the mortality rate from eczema herpeticum reaches 50% [ 9 ]. Further, the complications of eczema herpeticum can include meningoencephalitis, keratoconjunctivitis, and disseminated intravascular coagulation [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Extensive eczema herpeticum in a previously well child

et al. 2022

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Background Eczema herpeticum, also known as Kaposi varicelliform eruption, is a potentially life-threatening disseminated cutaneous viral infection. In the majority of cases, this condition develops as a complication in patients with atopic dermatitis. However, it may arise in a wide spectrum of pre-existing skin conditions, including psoriasis, seborrheic dermatitis, contact dermatitis, cutaneous T cell lymphoma, pemphigus vulgaris, and others. Case presentation We present the case of a 2-year-old boy who was brought to the emergency department because of a high-grade fever and rash. The fever started 2 days before his presentation, and its maximum measurement was 39.6°C. The following day, the patient developed numerous painful, pruritic vesiculopustular eruptions, and oozing involving the lips, rendering the patient unable to tolerate oral feeding. The patient was seen by the dermatology team who diagnosed the child as having eczema herpeticum. The patient was commenced on antiviral and empirical antibiotic therapy in the form of intravenous acyclovir and cephalexin along with topical fusidic acid and panthenol. The patient showed clinical improvement with resolution of the fever and partial involution of the rash 2 days following the administration of the antimicrobial therapy. Conclusion Eczema herpeticum is a rare clinical entity that can result in significant morbidity. The case highlights the importance of considering the diagnosis of eczema herpeticum in the appropriate clinical settings, even in patients who were not known to have any prior skin disorder.

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Section: Discussionmentioning

confidence: 99%

Extensive eczema herpeticum in a previously well child

et al. 2022

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“…However, HHV-2 infections above the waist have been increasing. These alterations in anatomic distribution may be due to changes in sexual behavior, with increased oral-genital contact between partners 6,24,25 . The results demonstrated one HHV-2 strain isolated from an orofacial lesion and one HHV-1 strain from a thigh lesion.…”

Section: Discussionmentioning

confidence: 99%

Isolation, typing, and acyclovir susceptibility of human herpesvirus 1 and 2 detected in Rio de Janeiro, Brazil

Lima

Mendes

Santos

2023

Revista Pan-Amazônica de Saúde

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OBJECTIVES: To isolate and identify human herpesvirus (HHV) strains circulating in healthy individuals in Rio de Janeiro, Brazil, and characterize their acyclovir (ACV) susceptibility. MATERIALS AND METHODS: Fifteen swabs from cutaneous or mucosal lesions were used to inoculate Vero cells for viral propagation. The species of the isolates were identified by amplifying and sequencing a portion of the conserved region of the herpesvirus DNA polymerase gene. ACV susceptibility was determined using dose-response assays. RESULTS: HHV strains were isolated from all 15 samples. Ten isolates belonged to species HHV-1 and five to species HHV-2. Susceptibility assays showed that 13 isolates were sensitive to ACV, one had intermediate resistance, and one was resistant. CONCLUSION: The results presented in this study demonstrate the circulation of HHV-1 and HHV-2 in healthy individuals in Rio de Janeiro, including ACV-resistant strains, and highlight the need for continued surveillance in the face of the emergence of HHV strains resistant to antiviral drugs used in the treatment of these infections.

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“…11,12 Valacyclovir and Famciclovir are recommended in patients not responding to acyclovir due to their better oral absorption. [11][12][13] However Valacyclovir is not recommended in less than 12 years of age. 11 Our dermatologists advise Famciclovir for any patient who develops allergic reaction to acyclovir, though no patient in this study needed it.…”

Section: Discussionmentioning

confidence: 99%

“…More specific investigations include serum herpes simplex virus IgM/IgG levels, transmission electron microscopy for identification of viral particles, PCR for viral DNA, viral culture, and direct fluorescence antibody staining and in atypical cases skin biopsy is required. 13,19 In burns, EH may be difficult to differentiate from shingles though lack of involvement of a particular dermatome is helpful in differentiating the two conditions clinically and PCR can provide the definitive diagnosis. 20 We also isolated the burn patients diagnosed with EH in separate room with separate bath area.…”

Section: Discussionmentioning

confidence: 99%

Eczema Herpeticum in children with burns

et al. 2021

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Background & Objective: Eczema herpeticum (EH) is a disseminated viral infection occurring in pre-existing skin conditions and burns. The objective of this study was to determine the frequency, treatment, and outcome of EH in pediatric burn patients. Methods: This retrospective study was conducted in the pediatric surgery department, King Edward Medical University/ Mayo Hospital, Lahore, from October 2015 to July 2018 after ethical approval. All pediatric burn patients diagnosed with EH and not sensitive to Acyclovir or suffering from chemical burns were enrolled in the study. Diagnosis was confirmed by presence of umbilicated lesions in burnt area and a positive Tzanck smear. Intravenous acyclovir and supportive treatment was started. Mortality, development of contractures, length of hospital stay/ time for wound healing, re-activation of EH was calculated. Results: Out of 3958 admitted pediatric burn patients, 94(2.4%) developed EH. Girls were 58(61.7%) and boys were 36(38.3%). Mean age was 5.16 ±2.88 years. Scald burn was in 43(45.7%) patients, flame burn in 48(51.1%) patients, and electric flash burn in 3(3.2%) patients. Mean TBSA was 21.74±10.38%. Vesicular eruptions settled in 92 (97.9%) patients after treatment with acyclovir. Mean duration of treatment was 19.89±8.9 days and hospital stay was 29.84±16.98 days. Twenty three patients (24.5%) developed contractures and two patients (2.1%) developed disseminated EH and expired. Six (6.4%) patients had re-activation of EH. Conclusion: EH occurred in 2.4% of admitted pediatric burn patients. Intravenous acyclovir was successful in 97.9% of the patients, although 2.1% developed disseminated EH and expired. Re-activation occurred in 6.4% of the cases and was associated with prolonged hospital stay. doi: https://doi.org/10.12669/pjms.37.2.3642 How to cite this:Naumeri F, Rijal S, Rashid AR, Ahmad HM. Eczema Herpeticum in children with burns. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3642 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Oral treatment with valacyclovir for HSV-2-associated eczema herpeticum in a 9-month-old infant

Cited by 9 publications

References 10 publications

Extensive eczema herpeticum in a previously well child

Extensive eczema herpeticum in a previously well child

Isolation, typing, and acyclovir susceptibility of human herpesvirus 1 and 2 detected in Rio de Janeiro, Brazil

Eczema Herpeticum in children with burns

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