静脉注射膦甲酸钠治疗儿童急性视网膜坏死中对阿昔洛韦耐药的2型单纯疱疹病毒感染
Intravenous foscarnet in the management of acyclovir-resistant herpes simplex virus type 2 in acute retinal necrosis in children.
作者信息
Khurana Rahul N, Charonis Alexander, Samuel Michael A, Gupta Anurag, Tawansy Khaled A
机构信息
Children's Retina Institute of California, Glendale, CA, USA.
出版信息
Med Sci Monit. 2005 Dec;11(12):CS75-8. Epub 2005 Nov 24.
BACKGROUND
Diagnosis and management of Acute Retinal Necrosis (ARN) in children that does not respond to systemic acyclovir treatment can be challenging. We report two cases of ARN secondary to herpes simplex virus (HSV) type 2 that was resistant to acyclovir but was treated successfully with intravenous foscarnet.
CASE REPORT
Two children diagnosed with ARN failed to show clinical response to systemic acyclovir treatment. Both cases had histories of previous HSV infections and vitreous taps positive for HSV-2. Both were converted to systemic foscarnet treatment with successful control of the retinitis and satisfactory visual outcomes.
CONCLUSIONS
Systemic foscarnet can be effective in the management of pediatric acute retinal necrosis caused by HSV-2 when there is an atypical response to conventional acyclovir treatment.
背景
对于系统性阿昔洛韦治疗无效的儿童急性视网膜坏死（ARN），其诊断和管理可能具有挑战性。我们报告两例继发于2型单纯疱疹病毒（HSV）的ARN病例，该病毒对阿昔洛韦耐药，但通过静脉注射膦甲酸钠成功治愈。
病例报告
两名被诊断为ARN的儿童对系统性阿昔洛韦治疗未显示出临床反应。两例均有既往HSV感染史，玻璃体液抽吸显示HSV-2阳性。二者均改用系统性膦甲酸钠治疗，视网膜炎症得到成功控制，视觉预后良好。
结论
当对传统阿昔洛韦治疗出现非典型反应时，系统性膦甲酸钠可有效治疗由HSV-2引起的儿童急性视网膜坏死。
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