High-dose oral acyclovir for children at risk of disseminated herpesvirus infections.
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Biomedical subjects
Publications and source records attributed to G D McKendrick.
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Forty-one patients with herpes zoster were treated with acyclovir or placebo at a dosage of 400 mg five times a day by mouth for five days in a double-blind randomized domiciliary study. Acyclovir was shown to reduce the days of new lesion formation within the effected dermatome after day 0 (P = 0.049). No other statistical difference was demonstrated between the two groups although the trends for new lesion formation outside the dermatome, full crusting, involution and diminution of acute pain all favoured acyclovir.
In a double-blind, randomised trial, immune-competent adults with acute herpes zoster received either 5 mg/kg acyclovir (17) or placebo (20) intravenously three times daily. Acyclovir significantly improved rash development, as evidenced by reducing the time of new lesion formation and the times to vesicle collapse and full crusting. Pain at the end of treatment and at three months was less in the treated group but the difference was not statistically significant. Ocular involvement was not affected.
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An acute interstitial nephritis was found in a patient with sudden renal failure and lung infection caused by Legionella pneumophilia. Our patient regained and maintained normal renal function after a short period of dialysis support. The diagnosis should be considered in any patient with a chest infection complicated by acute renal failure especially if confusion is disproportionate to the degree of uremia.
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A survey was conducted in seven hospitals to assess the risk of cross-infection with the highly infectious air-borne diseases, varicella-zoster and measles, in isolation wards of different design. Existing wards and isolation techniques were found to afford a high degree of protection, but there was considerable variation in the incidence of cross-infection related to ward structure, ward practice and the availability of trained staff. Recommendations are made for the design of new isolation wards and for safe practice.
The symptoms of 100 hospitalised cases of rotavirus infantile gastroenteritis are described. Most patients presented with high fever between the 2nd and 5th day, having started with diarrhoea or vomiting or both. 42% of the infants had upper respiratory tract symptoms. Severe electrolyte disturbance did not occur, although there was a suggestion of a correlation between the higher blood ureas and the number of rotavirus particles in the stools. The mean duration of illness of uncomplicated cases was 13.4 days. Infants were more severely affected when enteropathic coliforms were also present, the total duration of illness being extended to 23 days. It is suggested that rotavirus or similar virus infection may be an essential precursor in the majority of coliform gastroenteritis.
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